PRESENT INDICATIONS FOR THE TREATMENT OF HEMATOLOGIC MALIGNANCIES WITH HIGH-DOSE RADIOCHEMOTHERAPY AND ALLOGENEIC OR AUTOLOGOUS HEMATOPOIETIC STEM-CELL SUPPORT

High-dose radiochemotherapy followed by the transfusion of allogeneic or autologous haemopoietic stem-cells (also referred to as bone marrow or peripheral blood stem-cell transplantation) has emerged as a new t reatment modality of lymphohaemopoietic malignancies. Allogeneic bone marrow transplantation has proven curative efficacy even in patients, who have no or only small prospective of cure of their disease by conv entional radiochemotherapy. Advances in the prevention and treatment o f procedure related complications have contributed to a considerable i mprovement in the clinical results of allogeneic marrow transplantatio n during recent years. The increasing number of volunteer unrelated ma rrow donors allows now the extention of allogeneic marrow transplantat ion to patients lacking a histocompatible family donor. Broadly accept ed indications for allogeneic marrow transplantation are acute leukaem ias and chronic myelogenous leukaemia in all disease stages. Current c linical trials are investigating allogeneic marrow transplantation as a treatment option for myelodysplastic syndromes, malignant lymphomas, and multiple myeloma. The value of intensified radiochemotherapy with autologous bone marrow or peripheral blood stem-cell support is studi ed in patients with leukaemia, malignant lymphoma, and multiple myelom a. New developments in the detection of minimal residual disease, in t he prevention and treatment of infectious and immunologic complication s, in supportive care especially through the application of haemopoiet ic growth factors as well as in immunomodulating interventions further support the expectation that some of the different approaches to high -dose radiochemotherapy will gain an established place in the treatmen t of haematologic malignancies.