[Autologous bone marrow transplantation in children with acute leukemia]

Eight children with acute leukemia were treated with chemoradiotherapy or high-dose chemotherapy followed by infusion of autologous marrow unpurged or purged mainly with monoclonal antibodies. Four were treated in their first remission, three in their second remission, and one in the fourth remission. Patients were isolated in laminar air flow rooms with sterile conditioning. Infused mononuclear cells ranged from 1.0 to 3.8 x 10(7)/kg. Hematologic engraftment was obtained in five patients. The other three patients, who were treated with monoclonal antibody or drug, received unpurged back up marrow because of delayed bone marrow reconstitution. Two recovered, but one died before engraftment. Hematologic recovery was delayed after autologous bone marrow transplantation. The median time to achieve 1,000 leukocytes/microliters, 500 neutrophils/microliters, and last platelet transfusion was 36 days (12-90), 36 days (12-90), and 70 days (39-214), respectively. Moreover, further increases beyond these levels remained unusually slow, especially in platelets. Two of eight patients relapsed at 5 and 15 months and the other patient died of interstitial pneumonitis. Actuarial disease free survival was 62.5%. There was a trend toward improved disease free survival for patients transplanted in the first remission (100%).