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Autologous Bone Marrow Transplantation for Acute Myeloid Leukemia

^a The University of Toronto Autologous Blood and Marrow Transplant Program, The University of Toronto, Toronto, Ontario, Canada;
^b Arlington Cancer Center, Arlington, Texas, USA

Key Words. Bone marrow transplantation • Acute myeloid leukemia • Chemotherapy • Purging • Bone marrow • Blood cells

Dr. A. Keating, The Toronto Hospital, General Division, Mulock-Larkin Wing 2-036, Toronto, ONT, Canada, M5G 2C4.

Despite progress over the past three decades, most patients with acute myeloid leukemia (AML) treated with conventional chemotherapy alone relapse and die of recurrent leukemia. Treatments used to improve outcome include allogeneic (alloBMT) and autologous bone marrow transplantation (ABMT). Indications for transplantation and the relative merits of alloBMT and ABMT remain unclear. In this review, we evaluate evidence supporting a role of ABMT in AML and compare the results with outcomes after alloBMT. In addition, we discuss areas of controversy including the optimal timing for ABMT, the role of bone marrow purging, the place of peripheral blood stem cell collection, the high dose regimen, and post-transplant immunotherapy to reduce relapse.

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