[异基因骨髓移植后白血病复发的分析]
[The analysis of leukemic relapse after allogeneic bone marrow transplantation].
作者信息
Yoshimura M, Yoshida H, Matsunashi T, Hidaka S, Kobayashi M, Yoshida S, Tominaga N, Tejima H, Hiraoka A, Nakamura H
机构信息
Center for Adult Disease, Osaka.
出版信息
Rinsho Ketsueki. 1991 Nov;32(11):1433-8.
This report presents the analysis of leukemic relapse of 52 patients who received allogeneic bone marrow transplantation between July 1984 and May 1990. Conditioning regimen consisted of TBI + CY and GVHD prophylaxis consisted of cyclosporin-A and methotrexate. The relapse ratios of chronic myelogenous leukemia (CML) (21 in chronic phase, 1 in accelerated phase, 1 in blastic crisis), acute nonlymphocytic leukemia (ANLL) (all 17 in 1st CR), acute lymphocytic leukemia (ALL) (all 12 in 1st CR) were 13%, 18%, 25%, respectively, and 3 year disease free survival (DFS) was as follows, CML 68%, ANLL 72%, ALL 49%. Regarding acute GVHD grading and chronic GVHD presence, 3 year DFS was as follows, acute GVHD 0 degree: 59%, I degree: 78%, II degree-IV degree: 53%, chronic GVHD (+): 82% GVHD (-): 77%. In our center leukemic relapse has been the major cause of death after BMT since 1984. Among 9 relapsed cases, one recurred more than 3 years after BMT, and another one got recurrent leukemia of donor origin.
本报告对1984年7月至1990年5月间接受异基因骨髓移植的52例患者的白血病复发情况进行了分析。预处理方案包括全身照射（TBI）+环磷酰胺（CY），移植物抗宿主病（GVHD）预防方案包括环孢素A和甲氨蝶呤。慢性粒细胞白血病（CML）（慢性期21例，加速期1例，急变期1例）、急性非淋巴细胞白血病（ANLL）（均为第1次完全缓解期的17例）、急性淋巴细胞白血病（ALL）（均为第1次完全缓解期的12例）的复发率分别为13%、18%、25%，3年无病生存率（DFS）如下：CML为68%，ANLL为72%，ALL为49%。关于急性GVHD分级和慢性GVHD的存在情况，3年DFS如下：急性GVHD 0度：59%，I度：78%，II度-IV度：53%，慢性GVHD（+）：82%，GVHD（-）：77%。自1984年以来，在我们中心白血病复发一直是骨髓移植后死亡的主要原因。在9例复发病例中，1例在骨髓移植后3年以上复发，另1例发生供者来源的复发性白血病。
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