[Modern treatment of leukemia and hematopoietic stem cell transplantation]. / Savremeno lecenje leukemija i transplantacija maticne celije hematopoeze.

ABSTRACT

The paper presents the possibilities of contemporary treatment of acute and chronic leukemia that have been based on new knowledge and experience we have gathered through clinical and scientific work. Contemporary treatment of leukemia is very complex and requires the application of cytostatics, biological therapy and transplantation of hematopoietic stem cells. The treatment of acute leukemia by cytostatics and induction protocols results in a rather high percentage of remissions, but unfortunately most of them cannot be preserved. Allogenic transplantation of hematopoietic stem cells from bone marrow or peripheral blood have given the best results in the treatment of acute and chronic leukemia. Anti-leukemic effect is bound to the previous chemoradiotherapy, particularly to the activity of donor's immunocompetent cells in the transplant, having an effect of a graft against leukemia. The cleansing of the autograft and isolation of stem cells together with the application of IL-2 will be a significant improvement of the efficacy of autologous transplantation in leukemia. It is realistic to expect that the treatment of malignant diseases such as leukemia will in near future, besides the already existing treatment methods, include molecular therapy at various cell levels, which will make possible a correction of the basic disorder in the process of malignant alteration of hematopoietic cells.