Niederwieser Dietger, Gentilini Chiara, Hegenbart Ute, Lange Thoralf, Becker Cornelia, Wang Song-Yau, Bartsch Kristina, Pönisch Wolfram, Raida Martin, Al-Ali Haifa
Department of Internal Medicine II, Division of Hematology and Oncology, University of Leipzig, Johannisallee 32 A, D-4103 Leipzig, Germany.
Crit Rev Oncol Hematol. 2005 Nov;56(2):275-81. doi: 10.1016/j.critrevonc.2005.03.016. Epub 2005 Oct 5.
The majority of patients with acute leukemia enter complete remission following induction therapy, but relapse despite consolidation and maintenance chemotherapy. Allogeneic hematopoietic cell transplantation (HCT) is the most effective consolidation therapy but unfortunately associated with high transplant-related mortality (TRM). In order to decrease TRM but still apply a graft-versus-tumor effect, allogeneic HCT protocols with reduced-intensity conditioning were developed and more than 5000 HCT, of which 1500 for acute leukemia, performed. Detailed information is available on more than 400 patients with acute leukemia. The results, summarized in this article, confirm that reduced-intensity preparative regimens lead to full donor chimerism and to generation of graft-versus-leukemia (GvL) effects with curative potential in older patients (>60 years). Prospective-controlled clinical trials are needed in younger patients to compare results of HCT after reduced-intensity conditioning to those of HCT with conventional conditioning.
大多数急性白血病患者在诱导治疗后进入完全缓解期，但尽管进行了巩固和维持化疗仍会复发。异基因造血细胞移植（HCT）是最有效的巩固治疗方法，但不幸的是与高移植相关死亡率（TRM）相关。为了降低TRM但仍发挥移植物抗肿瘤作用，开发了强度降低的预处理方案的异基因HCT方案，并进行了5000多次HCT，其中1500例用于急性白血病。有400多名急性白血病患者的详细信息。本文总结的结果证实，强度降低的预处理方案可导致完全供体嵌合，并产生具有治愈潜力的移植物抗白血病（GvL）效应，适用于老年患者（>60岁）。需要在年轻患者中进行前瞻性对照临床试验，以比较强度降低的预处理后HCT与传统预处理HCT的结果。
