[Bone marrow transplantation as potential therapeutic strategy to cancers]

During a period from 1973 to September, 1981 allogeneic(Allo-) and syngeneic (Syn-) marrow transplantation (BMT) was performed in Japan according to Thomas' method to 41 patients with acute leukemia, 6 of whom (15%) have survived in long-term (3 1/2 years at maximum). This result was roughly compared with that obtained by Thomas et al. until 1977. Interstitial pneu-monia and infections were the main (80%) cause of death. Since October, 1980, following Thomas, recommendation, our BMT team performed Allo-BMT to 5 leukemic patients in complete remission, 2 of whom (40%) are for 14 and 10 months post-transplant in unmaintained remission. According to the previously described method, our BMT team performed autologous BMT (Auto-BMT) to 4 patients with acute leukemia and 11 with several cancers of undifferentiated cell type. The 4 leukemics achieved earlier complete remission, but all died of relapse, thus suggesting that Auto-BMT is only one of supportive therapies. Results of Auto-BMT performed to 5 patients with malignant lymphoma, encouraged by our experience of Allo-BMT to a patient with malignant lymphoma of CS IV, who survived with no chemotherapy 10 1/2 months posttransplant, showed that one patient is alive for 22 months posttransplant in unmaintained remission, and patients have relapsed 2, 6 and 14 1/2 months posttransplant, but are still alive for 25, 14 and 28 months posttransplant, respectively, well responding to chemotherapy. One of 2 patients with nasopharyngeal carcinoma is healthy for 2 years posttransplant in unmaintained remission. The remaining 5 patients died of either infections or relapse. Relapse in both Allo- and Auto-BMT cases, and infectious complications, and no covering of expenses for BMT by health insurance were main problems in Japan and how to solve them were discussed. As compared to Allo-BMT, Auto-BMT seems to be a safe and convenient strategy against solid tumors.