OBJECTIVE. To study the use of autologous bone marrow transplantation to treat acute myeloid leukaemia when complete remission had been achieved and when no human leukocyte antigen-matched related donor was available.

DESIGN. Prospective follow-up study.

SETTING. Government hospital, Hong Kong.

PATIENTS. Eight patients (median age, 34 years [range, 16-45 years]) with acute myeloid leukaemia in whom complete remission had been achieved.

INTERVENTION. Conditioning regimen of carmustine, amsacrine, etoposide VP-16, cytarabine, and infusion of unpurged marrow.

MAIN OUTCOME MEASURES. Median time taken to reach neutrophil and platelet counts of >/=0.5 x 10^9 /L and >/=20 x 10^9 /L, respectively; mortality and relapse rates; and follow-up regimens used.

RESULTS. Engraftment was successfully achieved in all patients and there were no early procedure-related mortalities. The median times required to reach a neutrophil count of >/=0.5 x 10^9 /L and a platelet count of >/=20 x 10^9 /L were 30 days (range, 18-36 days) and 38 days (range, 15-53 days), respectively. The median duration of hospital stay was 37 days (range, 25-43 days). Two patients died of a relapse of leukaemia at 6 and 9 months post-transplantation. Two patients experienced relapses: one at 8 months post-transplantation, for which conventional chemotherapy was restarted, and one at 18 months; treatment with all-trans-retinoic acid and conventional chemotherapy achieved a third complete remission in the latter patient, who had acute promyelocytic leukaemia. Continuous remission has been achieved in four of the eight patients after a median follow-up duration of 26 months (range, 6-43 months).

CONCLUSION. Autologous bone marrow transplantation is an acceptable treatment for patients with acute myeloid leukaemia who lack a human leukocyte antigen-matched related donor.

Key words: Antineoplastic agents, combined; Bone marrow transplantation; Combined modality therapy; Leukemia, myelocytic, acute; Survival analysis

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