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Twenty years of bone marrow transplantation in Essen - 1995 update.

Allogeneic BMT provides potential life-saving therapy for a variety of inherited and acquired diseases of the hemopoietic and the immune systems, including malignancies. At the University of Essen more than 800 transplants have been performed during the past 20 years. CML was the most frequent indication for BMT in Essen. Patients transplanted in first chronic phase had a high probability of disease-free survival, whereas patients transplanted with more advanced disease had long-term remission only in a minority of cases. With AML, optimal timing for transplantation remains undetermined. Patients at high risk of chemotherapy failure and relapse may have a better overall chance of long-term disease-free survival and cure if transplanted in first remission. BMT for patients with ALL are generally reserved for patients failing chemotherapy or in first remission with prognostic factors predicting a high risk of failure with chemotherapy alone. Compared with conventional bone marrow harvest, the advantages of mononuclear-blood-cell apheresis will probably change the standard procedure for bone marrow harvest in the future. Since 1995, an increasing number of blood stem cell transplants have been successfully performed in allogeneic transplants at the University of Essen.