Reiffers J, Labopin M, Sanz M, Korbling M, Blaise D, De La Rubia J, Gorin N C
Service d'Hématologie, CHU Bordeaux, Pessac, France.
Bone Marrow Transplant. 2000 Jun;25(11):1115-9. doi: 10.1038/sj.bmt.1702389.
In order to compare autologous bone marrow (BMT) and blood cell transplantation (BCT) in patients with acute myeloid leukemia (AML) in first remission (CR1), we retrospectively reviewed the data of 1393 patients registered to EBMT and undergoing either BCT (n = 100), purged (n = 252) or unpurged (n = 1041) BMT. Hematopoietic recovery was significantly quicker after BCT than after either purged or unpurged BMT. The 2-year leukemia-free survival (LFS), relapse incidence (RI) and overall survival for the entire population of patients were 52 +/- 1%, 43 +/- 1% and 58 +/- 1% and were significantly influenced by FAB subtype (M3 vs other) and the intervals between diagnosis and CR1 or CR1 and transplant. After BCT, LFS and RI were 44 +/- 6% and 50 +/- 6% and did not differ significantly from that found for unpurged BMT (49 +/- 2% and 45 +/- 2%; P = NS). However, LFS (57 +/- 3%) and RI (37 +/- 3%) of patients undergoing purged BMT were significantly different from that found for BCT patients (P = 0.01 and P = 0.006). As some characteristics of patients undergoing BCT or purged BMT differed significantly (age, intervals between diagnosis and CR1 or CR1 and transplant), the better outcome observed for purged BMT over BCT patients needs to be prospectively investigated.
为了比较首次缓解期（CR1）急性髓系白血病（AML）患者的自体骨髓移植（BMT）和血细胞移植（BCT），我们回顾性分析了1393例登记到欧洲血液与骨髓移植协会（EBMT）并接受BCT（n = 100）、净化（n = 252）或未净化（n = 1041）BMT的患者数据。BCT后的造血恢复明显快于净化或未净化BMT后的造血恢复。整组患者的2年无白血病生存率（LFS）、复发率（RI）和总生存率分别为52±1%、43±1%和58±1%，且受FAB亚型（M3与其他亚型）以及诊断与CR1或CR1与移植之间的间隔时间显著影响。BCT后，LFS和RI分别为44±6%和50±6%，与未净化BMT的结果（49±2%和45±2%；P = 无显著性差异）无显著差异。然而，接受净化BMT患者的LFS（57±3%）和RI（37±3%）与BCT患者的结果显著不同（P = 0.01和P = 0.006）。由于接受BCT或净化BMT患者的一些特征存在显著差异（年龄、诊断与CR1或CR1与移植之间的间隔时间），净化BMT患者比BCT患者观察到的更好结果需要进行前瞻性研究。
