Inoue Masami, Yasui Masahiro, Sawada Akihisa, Koyama Maho, Kondo Osamu, Miyamura Takako, Higuchi Banryoku, Kouroki Masahiko, Ishihara Takashi, Kawa Keisei
Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health.
Rinsho Ketsueki. 2007 Nov;48(11):1470-7.
The results of allogeneic stem cell transplantation for patients with chemotherapy-resistant non-remission acute leukemia have been very poor. We have used a melphalan-preceding intensified preparative regimen in which a six-day interval is set between melphalan 70 mg/m2 and the main part of the preparative regimen to avoid toxicity in 15 consecutive pediatric patients with refractory acute leukemia. Only one patient died of transplant-related toxicity within 100 days of transplant. One patient had refractory anemia originating from donor cells at three months after transplant. Eight patients relapsed at a median of six months after transplant; therefore, five of 15 patients have been in complete remission (CR) for a median of 61 months. Four of six patients who did not have blasts in their peripheral blood before melphalan are in CR This method seems to be safe and effective for refractory acute leukemia.
化疗耐药的未缓解急性白血病患者接受异基因干细胞移植的结果一直很差。我们采用了一种先使用美法仑的强化预处理方案，在70mg/m²美法仑与预处理方案的主要部分之间设置6天的间隔，以避免15例连续性难治性急性白血病儿科患者出现毒性反应。仅1例患者在移植后100天内死于移植相关毒性反应。1例患者在移植后3个月出现源自供体细胞的难治性贫血。8例患者在移植后中位时间6个月时复发；因此，15例患者中有5例处于完全缓解（CR）状态，中位缓解时间为61个月。在使用美法仑前外周血中无原始细胞的6例患者中有4例处于CR状态。这种方法对于难治性急性白血病似乎是安全有效的。
