Isogeneic Marrow Grafts for Hematologic Malignancy in Man

Since total body irradiation can exert an antileukemic effect, and since death from aplasia induced by otherwise lethal doses of whole body irradiation can be prevented by infusion of isogeneic marrow, attempts have been made to treat patients having acute leukemia with total body irradiation and infusion of marrow from an identical twin.^1-3 Although this approach occasionally has been effective in some animal models,^4-6 its effect in man has been discouraging because leukemia has recurred within 7 to 12 weeks.⁷

This report describes results of treatment of five patients having hematologic malignant neoplasms refractory to conventional therapy. These patients were treated with supralethal total body irradiation and isogeneic marrow infusion. One was given maintenance chemotherapy immediately after grafting and four of the patients received "immuno-therapy." The latter was based largely on the assumed existence of tumor-specific antigens on human leukemic cells,^8-11 on studies of eradication of