PMID: 9179277May 1, 1997Paper

Bone marrow transplantation for acute lymphocytic leukemia (ALL)

Leukemia
Daniel Weisdorf

Abstract

Patients with high-risk acute lymphocytic leukemia (ALL) in first complete remission, or those with relapsed leukemia, are unlikely to have their disease controlled by conventional therapeutic approaches. Bone marrow transplantation has been shown to produce extended leukemia-free survival for a substantial number of patients, making it the preferred treatment approach. However, differential availability, transplant-associated mortality, and antileukemic efficacy of various transplant options makes the choice between donor-cell sources problematic. Currently, patients can have transplantation therapy using either autologous marrow cryopreserved with or without purging, allogeneic related-donor, or umbilical-cord blood cells used for reconstitution. Transplants with autologous marrow or related-donor marrow can be undertaken with relative speed. In contrast, searching for an available unrelated living donor and the logistics of arranging for a donor harvest requires several months. Use of umbilical cord blood is more expeditious and may greatly accelerate the availability of unrelated allogeneic autotransplants and in the safety of unrelated-donor transplantation are needed to improve outcomes of transplantation in patients with...Continue Reading

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