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首次完全缓解的急性髓系白血病患者的自体和异基因骨髓移植:热那亚159例患者的经验更新

Autologous and allogeneic bone marrow transplantation in acute myeloid leukemia in first complete remission: an update of the Genoa experience with 159 patients.

作者信息

Carella A M, Frassoni F, van Lint M T, Gualandi F, Occhini D, Carlier P, Pollicardo N, Pungolino E, Fagioli F, Santini G

机构信息

Bone Marrow Transplantation Unit, Ospedale S. Martino, Genoa, Italy.

出版信息

Ann Hematol. 1992 Mar;64(3):128-31. doi: 10.1007/BF01697399.

Abstract

In the attempt to evaluate the role of Autologous and Allogeneic Bone Marrow Transplantation, we have retrospectively analyzed 159 patients with Acute Myeloid Leukemia in first complete remission treated in our Unit, most of whom were referred from other Institutions. High-dose therapy was uniform and consisted of cyclophosphamide 60 mg/kg/d on two consecutive days and TBI in a single dose (10 Gy) for ABMT patients and in fractionated doses (3.3 Gy x 3 days) for BMT patients. Eight years actuarial survival was similar in two groups (52% for BMT and 49% for ABMT). The actuarial risk of relapse for BMT and ABMT was 29% and 43%, respectively. Considering that none of ABMT patients was "purged" with in vitro technique, this review seems to confirm the importance of "in vivo" purging with postremission intensification, immediately before the harvesting. Of course, more patients and a longer follow-up are needed to draw final conclusions.

摘要

为了评估自体和异体骨髓移植的作用,我们回顾性分析了在本单位接受治疗的159例首次完全缓解的急性髓系白血病患者,其中大多数患者来自其他机构。高剂量治疗方案统一,ABMT患者连续两天给予环磷酰胺60mg/kg/d,并单次给予全身照射(10Gy),BMT患者则分次给予全身照射(3.3Gy×3天)。两组患者的8年精算生存率相似(BMT组为52%,ABMT组为49%)。BMT和ABMT的复发精算风险分别为29%和43%。考虑到没有ABMT患者采用体外技术进行“净化”,本综述似乎证实了在缓解后强化治疗、即将采集前进行“体内”净化的重要性。当然,需要更多的患者和更长时间的随访才能得出最终结论。

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