Usefulness of Double Bone Marrow Transplantation

Repeated Courses of Bone Marrow Transplantation in Children

Abstract

We studied the results of 12 children who received repeated courses of bone marrow transplantation (BMT). One with acute lymphoblastic leukemia (ALL) who had relapsed 40 months after the first allogeneic BMT was retransplanted in complete remission (CR) and remains disease-free more than 74 months after the 2nd BMT. Three out of the four children with malignancies who received BMT in relapse achieved CR but one of the four did not respond to BMT. These four children in relapse who were treated by the 2nd BMT died of progressive disease. Three children with relapsed diseases of yolk sac tumor, ALL or neuroblastoma were treated by double BMT. All patients achieved CR after the 1st BMT and remains in CR 17, 21 and 8 months after the 2nd BMT, respectively. They did not show severe complications or graft-versus-host diseases. Four children with incomplete marrow recovery who were converted hematologically into the donor phenotypes were successfully treated by the 2nd BMT without conditioning. In conclusion, double BMT may be promising for high risk patients and regimen related toxicities could be tolerable.