AUTOLOGOUS MARROW TRANSPLANTATION FOR PATIENTS WITH ACUTE NONLYMPHOBLATIC LEUKEMI

自体骨髓移植(AMT)在骨髓移植中的作用 急性非淋巴细胞白血病(ANL)的治疗 将会被评估。将在#年进行随机试验。 与西南肿瘤学小组(SWOG)合作确定 AMT的疗效和合适的时机。ANL Who患者 达到缓解将是人类白细胞抗原分型。那些捐赠者匹配的人 将被提供同种异体移植。那些没有匹配的人 捐献者的骨髓将在4-氢过氧循环后进行冷冻- 磷酰胺(4-HC)治疗。然后他们将被随机分配到 首次缓解或接受大剂量治疗时接受AMT 联合化疗联合AMT保留至首次复发。 这将允许比较：1)自体移植与 首次完全缓解的同种异体移植和2)首次的自体移植 保留自体移植的完全缓解与化疗的比较 直到第一次复发。此外，我们将尝试定义更多 明确首次复发的急性心肌梗死的治疗潜力 在疾病的这个阶段移植更多的患者 没有登记在SWOG研究中。

The role of autologous marrow transplantation (AMT) in the treatment of patients with acute nonlymphoblastic leukemia (ANL) will be evaluated. A randomized trial will be carried out in cooperation with the Southwest Oncology Group (SWOG) to determine the efficacy and appropriate timing of AMT. Patients with ANL who achieve remission will be HLA typed. Those with matched donors will be offered allogeneic transplantation. Those without matched donors will have marrow cryopreserved following 4-hydroperoxycyclo- phosphamide (4-HC) treatment. They will then be randomized to receive AMT in first remission or to be treated with high dose combination chemotherapy with AMT reserved until first relapse. This will allow for a comparison of: 1) autografts versus allografts in first complete remission and 2) autografts in first complete remission versus chemotherapy with autografting reserved until first relapse. In addition, we will attempt to define more clearly the curative potential of AMI at first relapse by transplanting additional patients at this stage of disease who are not registered on the SWOG study.