Yazaki M, Miyamura K, Kojima S, Kodera Y, Hirabayashi N, Horibe K, Morishima Y, Wada Y
Department of Pediatrics, Nagoya City University Medical School.
Rinsho Ketsueki. 1991 Aug;32(8):851-4.
We reported the results of 6 allogenic bone marrow transplantation (BMT) and 3 autologous BMT for patients with Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukemia (ALL) by Nagoya BMT group. Two of six patients who received allogenic BMT have continued complete remission (CR) on +639 days and +1,597 days. Four of six patients relapsed on +134, +203, +216, and +267 days. Two patients with a disease-free survival for a long time had both acute and chronic GVHD. It is suggested that graft-versus-leukemia (GVL) effect might prevent the relapse. On the contrary, one patient who received with monoclonal antibodies plus complement-treated autologous bone marrow is free of leukemia on +439 days. Our results suggest the follows. 1) We do chromosomal analysis at initial diagnosis in all cases to do BMT in first CR. 2) We intensify the conditioning regimen for BMT. 3) We study on application of GVL effect to prevent the relapse. 4) We establish the best purging method to eradicate residual leukemic cells for autologous BMT. 5) We do allogenic BMT using HLA-matched unrelated donor for patients without related donor.
我们报告了名古屋骨髓移植组对6例费城染色体（Ph1）阳性急性淋巴细胞白血病（ALL）患者进行异基因骨髓移植（BMT）和3例自体BMT的结果。接受异基因BMT的6例患者中有2例分别在+639天和+1597天持续完全缓解（CR）。6例患者中有4例分别在+134、+203、+216和+267天复发。2例长期无病生存的患者均发生了急性和慢性移植物抗宿主病（GVHD）。提示移植物抗白血病（GVL）效应可能预防复发。相反，1例接受单克隆抗体加补体处理的自体骨髓的患者在+439天时无白血病。我们的结果提示如下：1）所有病例在初诊时均进行染色体分析，以便在首次完全缓解时进行BMT。2）我们强化了BMT的预处理方案。3）我们研究GVL效应在预防复发中的应用。4）我们建立最佳的净化方法以清除自体BMT中残留的白血病细胞。5）对于没有相关供者的患者，我们使用HLA匹配的无关供者进行异基因BMT。
