AUTOLOGOUS BLOOD STEM-CELL TRANSPLANTATION FOR HEMATOLOGICAL MALIGNANCY - TREATMENT-RELATED MORTALITY OF 2-PERCENT

Background: Lengthy remission or cure has remained elusive for patients with many of the common haematological malignancies. Thus high dose chemotherapy followed by autologous haemopoietic stem cell transplantation is being increasingly utilised in these diseases. Aim: To assess the safety of high dose chemotherapy and autologous stem cell transplantation in haematological malignancy. Methods: Forty-eight patients with haematological malignancy were given high dose chemotherapy followed by an infusion of previously cryopreserved autologous peripheral blood stem cells with (patients with acute myeloid leukaemia [AML]) or without (patients with acute lymphoblastic leukaemia [ALL], chronic myeloid leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease and myeloma) autologous bone marrow. Results: All patients except one had sustained engraftment. The median (range) number of days to attain a neutrophil count of 0.5 x 10(9)/L was 12 (10-42) and a platelet count of 20 x 10(9)/L unsupported by platelet transfusions was 15 (eight to 155). Other than oropharyngeal mucositis and febrile neutropenia, morbidity was low. Two patients had haemorrhagic cystitis, one hepatic veno-occlusive disease and one interstitial pneumonitis; all resolved. The treatment-related mortality was 2% - a single patient with AML died of failure of sustained engraftment. Conclusions: Autologous blood stem cell transplantation to support high dose chemotherapy is a relatively safe procedure and its efficacy is currently being explored in a wide range of haematological malignancies.