Bone marrow transplantation represents an effective therapy for acute myelogenous leukemia. Despite its initial use in patients in late stages of their disease, the best results have been documented when the procedure is undertaken while in first complete remission. Recent advances in the management of the neutropenic patient have guaranteed the safe use of aggressive chemoterapy regimens, resulting in a prolonged disease free survival, similar to what is documented after myeloablative regimens. Doubts still remain as of which patients should be submitted to marrow transplantation and at which stage of their disease. Cytogenetics and a better definition of other biological characteristics will allow a better selection of patients. The control of graft versus host disease, improvement in the management of infectious complications, the use of nonmyeloablative conditioning regimens and a greater availability of unrelated marrow donors will permit a greater use of allogeneic marrow transplantation in acute myelogenous leukemia, including elderly patients. The role of autologous transplantation must be better defined.
acute myelogenou leukemia; bone marrow transplantation treatment
