Yumura-Yagi K, Inoue M, Sakata N, Okamura T, Yasui M, Sawada A, Sato E, Chayama K, Endo C, Sasabe M, Miyamura T, Park Y-D, Nakano T, Inagaki J, Kishimoto T, Nomura K, Saito I, Hamada S, Nakano T, Hashii Y, Kawa K
Department of Pediatrics, Osaka General Medical Center, Osaka, Japan.
Bone Marrow Transplant. 2005 Aug;36(4):307-13. doi: 10.1038/sj.bmt.1705056.
In all, 100 unrelated donor bone marrow transplantations (UD-BMT) were performed in our institute between October 1993 and January 2003. Of 93 evaluable patients, 73 patients had hematological malignancy, 13 had nonmalignancy and seven had lymphoproliferative disease. The estimated 9-year event-free survival (EFS) rate was 57.1+/-5.5% in all patients. In the following analyses of the patients with hematological malignancy, the standard group had significantly better EFS than the high-risk group (61.5+/-7.0 vs 35.6+/-9.7%, P=0.02), and the EFS rate of the tacrolimus (FK-506)+methotrexate (MTX)+/-methylprednisolone prophylactic group for graft-versus-host disease was superior to that of the FK-506 without MTX group (75.7+/-8.0 vs 55.8+/-7.6%, P=0.02). When we compared the EFS rates of the FK506+MTX+/-methylprednisolone (mPSL) group and the HLA-matched related donor BMT group in our institute, these were almost similar (75.7+/-8.1 vs 68.4+/-9.3%). Therefore, UD-BMT using FK-506+MTX+/-mPSL is a safe and useful method for children with hematological malignancy who require allogeneic BMT.
1993年10月至2003年1月期间，我院共进行了100例无关供者骨髓移植（UD - BMT）。在93例可评估的患者中，73例患有血液系统恶性肿瘤，13例患有非恶性疾病，7例患有淋巴增殖性疾病。所有患者的9年无事件生存率（EFS）估计为57.1±5.5%。在随后对血液系统恶性肿瘤患者的分析中，标准组的EFS明显优于高危组（61.5±7.0%对35.6±9.7%，P = 0.02），他克莫司（FK - 506）+甲氨蝶呤（MTX）±甲基强的松龙预防移植物抗宿主病组的EFS率优于无MTX的FK - 506组（75.7±8.0%对55.8±7.6%，P = 0.02）。当我们比较我院FK506 + MTX±甲基强的松龙（mPSL）组和HLA匹配的相关供者BMT组的EFS率时，两者几乎相似（75.7±8.1%对68.4±9.3%）。因此，对于需要异基因BMT的血液系统恶性肿瘤儿童，使用FK - 506 + MTX±mPSL进行UD - BMT是一种安全有效的方法。
