[Autografts and acute leukemia: 15 years later]

Autologous bone marrow transplantation (ABMT) is now widely used to consolidate patients with acute leukaemia. Results presently available indicate that the leukaemia free survival for adults autografted in first remission of acute myelocytic leukaemia (AML) is in the range of 50%, with better results achieved when using marrow purged with a cyclosphosphamide derivate: mafosfamide. Results in adult patients with acute lymphocytic leukaemia (ALL) autografted in first remission are in the range of 40%. In second remission, results obtained for AML and ALL in adults are in the range of 35% and 20% respectively. In children, results are better. Because ABMT can be used up to 60 years of age and because the transplant related mortality associated with autografting is much lower than the one following allografting, ABMT is now considered as a first choice therapeutic option in the absence of an HLA identical related donor, and/or in older patients. Epidemiologic studies from the "Centre International Greffes de Moelle Osseuse, hôpital St-Antoine, Paris" indicate that more than 1000 ABMT are performed each year worldwide for the treatment of acute leukaemias.