ABSTRACT
Curative aspirations are reasonable for patients who are fit to receive all available therapeutic approaches, including transplantation. This generally means focusing on patients under 55–60 years. The impressive anti-leukaemic effect mediated by allogeneic transplantation when it appeared in early 1980’s was so dramatically different from relative impotence of consolidation and/or maintenance chemotherapy. This resulted in several groups accumulating experience of Autologous Bone Marrow Transplantation mostly in the hope of exploiting an improved anti-leukaemic effect by serious dose escalation to myeloablative levels. While collective experiences of autografting in AML have continued to look encouraging, there has been growing recognition that selection biases exist. The relapse risk of a patient who enters remission diminishes with time, the effect of which is that patients who actually receive the transplant. Interestingly allogeneic BMT has not yet been subjected to such rigorous scrutiny. It seems legitimate to conclude, at the moment, that in whatever setting in first remission autograft does provide an improved anti-leukaemic effect.
