Autologous Transplantation

Autologous transplantation for adult ALL is even less successful than allogeneic transplantation.36 In part, this is likely related to the amount of disease burden prior to autologous transplantation and whether the residual leukemia cells were sufficiently eradicated prior to reinfusion. Many investigators have attempted to purge residual disease ex vivo by using different chemotherapeutic agents or monoclonal antibod-ies.37-41 Not only are results of autologous transplantation disappointing in second CR, but even in first CR this modality has a limited applicability. Both a non-randomized and a randomized trial in patients in first CR have shown no benefit to autologous transplantation compared with maintenance chemotherapy.4243 Therefore, autologous transplantation in patients with relapsed ALL should still be considered investigational and not routinely recommended to patients in first CR outside of a clinical trial.

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