Autologous bone marrow transplantation in acute leukemia

The role of autologous bone marrow transplantation (ABMT) in acute leukemia patients in first complete remission remains unclear despite randomized tr ials. Because protocol deviations, early relapse, and inappropriately high treatment-related mortality unequally affected the ABMT cohort, and because recent randomized trials have used old purging methodologies, it is not po ssible to conclude that ABMT is not beneficial. More recent studies show th at most patients are able to proceed with the intended ABMT and that modern purging may be associated with a treatment-related mortality rate of less than 5%. Immunomodulation and graft engineering uniquely suited to autologo us progenitor cells indicate that ABMT should continue to be studied in the management of acute leukemia.