[Chemotherapy and bone marrow transplantation for acute leukemia]

Chemotherapy (CT) and bone marrow transplantation (BMT) have made remarkable progress in recent years. The comparison of both treatment modalities has become an important issue. The methods of comparison, however, should be varied according to the subjects and purposes of comparison. For a general comparison of both CT and BMT, the registry data of both treatments, seems adequate. For the comparison of a CT regimen with a BMT regimen, a randomized control study seems most adequate. in order to get an overview. For the selection of treatment for a certain patient, comparison of CT and BMT data from the center in which the patient will be treated seems most important. As the latter comparison we have studied the rate of early death, the rate of long-term survival and medical costs in leukemia patients diagnosed and followed for 5 years, at the Center for Adult Diseases Osaka. The early death rate was similar in both groups of patients. The long-term survival rate was 78% in BMT and 28% in CT patients. Cost effectiveness was also favorable in BMT patients. Data on CT and BMT in each center should be prepared for the selection of treatment for patients at each center.