Meloni G, Vignetti M, Andrizzi C, Dallorso S, Bonetti F, Zanesco L, Madon E, Andolina M, Carella A M, De Laurenzi A
Bone Marrow Transplant. 1991;7 Suppl 3:80-3.
We report data from an Italian survey on ABMT in 93 AML children less than 14 years in 1st or 2nd remission performed in 15 Centers. Different conditioning regimens have been employed: BAVC, an original schedule of chemotherapy; TBI plus Cy and/or other drugs (TBI + CHT); other high dose chemotherapy schedules (HD CHT). 62 patients have been transplanted in 1st CR; 38 have been conditioned with BAVC, 16 with TBI + CHT and 8 with HD CHT. Relapses were 21 in the BAVC group (DFS = 35% at 66 months), 5 in the TBI group (DFS = 61% at 48 months) and 5 in the HD CHT group; overall DFS is 39% at 66 months. 31 patients have been transplanted in 2nd CR; 14 were conditioned with BAVC and 16 with TBI + CHT; 6 patients relapsed in the first group, DFS is 56% at 50 months; in the second group 2 early deaths and 3 relapses occurred, DFS is 65% at 65 months. 1 patient in 2nd CR, conditioned with HD CHT, died during aplasia. Overall DFS is 59% at 65 months. Although no final conclusions concerning ABMT in AML children may be drawn from this retrospective study because of heterogeneity of population and methods, results obtained in 2nd CR are clearly better to those obtained with standard chemotherapy alone, confirming the role of ABMT in this high risk category of patients.
我们报告了一项意大利的调查数据,该调查针对15个中心的93名年龄小于14岁、处于首次或第二次缓解期的急性髓系白血病(AML)儿童进行了自体骨髓移植(ABMT)。采用了不同的预处理方案:BAVC,一种原创的化疗方案;全身照射(TBI)加环磷酰胺(Cy)和/或其他药物(TBI + CHT);其他高剂量化疗方案(HD CHT)。62例患者在首次完全缓解(CR)时接受了移植;38例采用BAVC预处理,16例采用TBI + CHT预处理,8例采用HD CHT预处理。BAVC组复发21例(66个月时无病生存率[DFS] = 35%),TBI组复发5例(48个月时DFS = 61%),HD CHT组复发5例;总体66个月时DFS为39%。31例患者在第二次CR时接受了移植;14例采用BAVC预处理,16例采用TBI + CHT预处理;第一组有6例复发,50个月时DFS为56%;第二组发生2例早期死亡和3例复发,65个月时DFS为65%。1例在第二次CR时采用HD CHT预处理的患者在再生障碍期死亡。总体65个月时DFS为59%。尽管由于人群和方法的异质性,无法从这项回顾性研究中得出关于AML儿童ABMT的最终结论,但在第二次CR时获得的结果明显优于单纯标准化疗的结果,证实了ABMT在这类高危患者中的作用。