Autologous Bone Marrow Transplantation - Blog Science Connections

Concluding Remarks
Karel A. Dicke
I am impressed by the recent advances made in acute leukemia, Hodgkin's
disease, neuroblastoma, and breast cancer. In leukemia, the results of
autologous bone marrow transplantation (ABMT) in first complete remission
(CR1) are very promising; however, patient selection might be a problem.
Randomized studies need to be done, and the role of purging needs to be
established.
Significant progress has been made in the treatment of Hodgkin's
disease patients who are in relapse. It is also evident that, in Hodgkin's
disease, the same rules hold (i.e., the more responsive the disease is to
normal-dose chemotherapy, the higher the cure rate).
In neuroblastoma, poor prognosis grade HI and good prognosis grade IV,
high-dose cytoreduction is clearly the therapy of choice.
Interesting studies are going on in breast cancer, one of which is the in
vivo test of normal-dose chemotherapy response, identifying the patient
population which may benefit from high-dose chemotherapy. Hopefully,
randomized studies will be organized in stage IV disease and poor prognosis
stage II disease.
Last but not least, credit needs to be given to Drs. G. Spitzer, T. Philip, and
J. Armitage, who organized the first randomized study of ABMT in responsive
relapsed non-Hodgkin's lymphoma, the Parma study. This study is worldwide
and will attract many participants. Hopefully, it will be well under way at the
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