Conclusions:
The analysis of our case cohort including eight pediatric patients leads to the assumption that a salvage therapy with melphalan / cytarabine in primary refractory or multiply-relapsed acute leukemia could be a possible curative approach: We registered a complete or partial remission in 63% of cases with the possibility to proceed to allogeneic stem cell transplantation. It resulted in one year and three year survival rates of 50% and 29%, respectively. Future multicentre studies should be performed with higher patient numbers to verify these results and to identify differences in the response rates between various subgroups such as acute myeloid and acute lymphoblastic leukemias.