Hermann J, Fuchs D, Prager J, Palme H, Müller A, Füller J, Vogelsang H, Zintl F
Kinderklinik, Friedrich-Schiller-Universität Jena.
Kinderarztl Prax. 1992 Apr;60(2):35-9.
We report on our experience of bone marrow transplantation (BMT) in children with acute myeloblastic leukaemia (AML) and high risk of relapse (initial WBC greater than 20 x 10(9)/l, FAB M 5, M 6, M 7). 32 children were grafted between november 1982 and october 1991 at the Children's Hospital of the University of Jena. Two patients underwent an allogenous BMT in relapse and died from progressive disease. In 13 children an allogeneic BMT was performed in first complete remission. One patient relapsed, two patients died from severe acute graft-versus-host disease, and two patients died from encephalopathy and cardiomyopathy. Eight of the 13 patients are living and well 18 months to eight and a half year after BMT. Seventeen patients received an autologous (unpurged) BMT. Four of them relapsed four to seven months after BMT. The disease free survival (DFS) for the 29 patients grafted in remission was 0.65. There was no statistical significant difference in DFS between patients with allogeneic and autologous BMT. We conclude that in children with AML and high risk for relapse BMT offers a real chance for better survival. Autologous BMT avoids the problems of graft-versus-host disease and of finding suitable donors for allogeneic marrow transplantation.
我们报告了我们对急性髓细胞白血病(AML)且复发风险高(初始白细胞计数大于20×10⁹/L,FAB M5、M6、M7)儿童进行骨髓移植(BMT)的经验。1982年11月至1991年10月期间,耶拿大学儿童医院为32名儿童进行了移植。2例患者在复发时接受了异基因BMT,死于疾病进展。13名儿童在首次完全缓解时进行了异基因BMT。1例患者复发,2例患者死于严重的急性移植物抗宿主病,2例患者死于脑病和心肌病。13例患者中有8例在BMT后18个月至8年半时存活且状况良好。17例患者接受了自体(未净化)BMT。其中4例在BMT后4至7个月复发。29例在缓解期进行移植的患者的无病生存率(DFS)为0.65。异基因BMT和自体BMT患者的DFS无统计学显著差异。我们得出结论,对于AML且复发风险高的儿童,BMT为提高生存率提供了真正的机会。自体BMT避免了移植物抗宿主病以及为异基因骨髓移植寻找合适供体的问题。