ABSTRACT
Most children (60 to 70%) with acute lymphoblastic leukemia are cured with conventional chemotherapy. At the present time, it seems hazardous to propose autologous stem cell transplantation (ASCT) during the first CR given the fact that potential indications in CR1 involve a high level of residual disease in cases such as leukemias even hypodiploidy or children requiring more than 6-week induction chemotherapy to achieve remission. A post-induction quantitative PCR technique with assessment of the level of residual disease at one time point may be a relevant prognostic factor for future relapse. Nevertheless new techniques such as quantitative PCR should make it possible to determine the best time at which to harvest the marrow inoculum. In the context of adoptive immunotherapy, infusion of haploidentical lymphocytes harvested by cytapheresis from related donors transduced with suicide gene and infused after autologous stem cell transplantation could induce an anti-leukemic effect.
