[Autotransplants in leukemia: current status and perspectives]

Autotransplants in leukemia are controversial; their rationale and results have been questioned. Here we consider several issues central to this debate: (1) Are there convincing data that more intensive therapy increases cures; (2) Are results post autotransplant a consequence of the transplant or do they reflect subject-selection and time-to-treatment (time censoring) biases; (3) Does leukemia relapse after autotransplant develops from persisting leukemia cells in the subject or the graft; (4) Do autotransplants using hemopoietic stem cells from different sources have distinct outcomes; (5) Are immune mediated anti-leukemia mechanisms likely to prevent relapse after autotransplants; and (6) Can comparably intensive therapy be given without an autotransplant.