AUTOGRAFTING AS FIRST LINE TREATMENT FOR CHRONIC MYELOID-LEUKEMIA

Interest in autografting for chronic myeloid leukaemia and its clinica l relevance has revived in recent years. This followed observations th at with various chemotherapeutic regimens it was possible to achieve, temporarily at least, peripheral blood and bone marrow that were Phila delphia negative. Bone marrow or peripheral blood progenitor cells cou ld then be harvested and reinfused following a high dose procedure, ho pefully eliminating any residual disease, and resulting in prolonged d isease free survival. This ideal has not yet been successfully achieve d with current strategies. Recent results indicate that eliminating re sidual disease with current chemotherapy is not normally achievable. T he use of more sensitive technologies such as polymerase chain reactio n has revealed persistent disease in most if not all apparently Philad elphia negative cases. This is confirmed by results where disease rela pse occurs following transplant in these cases. Despite this, clinical ly relevant remissions are obtained and further trials are indicated. In this review present treatment is discussed and future strategies, u sing novel techniques as an adjunct to current treatment, are proposed that might improve on present results or even lead to the elusive goa l of cure.