AUTOLOGOUS MARROW TRANSPLANTATION FOR PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA

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The purpose of this subproject is to evaluate techniques for autologous marrow transplantation (AMI) which will improve the survival of patients with acute lymphoblastic leukemia (ALL) in second marrow remission. Since relapse is the major cause of death following AMI, a conditioning regimen that has been reported successful in decreasing relapse rates in recipients of allogeneic marrow grafts will be evaluated. Patients will receive marrow depleted of either T or B cells depending on lymphoblast phenotyping data. Outcome of autologous transplantation will be compared to that of similar allografted patients to determine relative efficacy. The cohort of patients accrued in this subproject along with those in subprojects I.B., I.C., and I.D. also will be eligible for administration of recombinant hematopoietic growth factors to overcome graft failure or to enhance engraftment (Project VI).