Marrow Transplantation in Patients with Acute Myeloid Leukemia in First Remission, First Relapse or Second Remission

Allogeneic marrow transplantation from HLA-identical siblings for patients with acute myeloid leukemia (AML) in first remission results in approximately 50% survival. Data reported by the Seattle team and the International Bone Marrow Transplant Registry indicate that most transplant regimens are associated with a 30% probability of transplant-related deaths, a 20% probability of relapse and 50% long-term survival [1, 2]. Most patients with AML in first remission have received unmodified allogeneic marrow after preparation with a regimen of cyclophosphamide (CY) plus total body irradiation (TBI). Many approaches have been investigated in an attempt to improve these results.