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.