Reiffers J
Unité de Greffe, CHR Bordeaux, Hôpital Haut-Levêque, Pessac, France.
Nouv Rev Fr Hematol (1978). 1990;32(5):289-91.
Forty-seven patients with Ph1-positive chronic myeloid leukemia in transformation (CML) underwent autologous transplantation of peripheral blood stem cells (ABSCT) collected at the original diagnosis before any treatment. They were treated according to 3 consecutive strategies: single transplant (Group I = 17 patients), double transplant (Group II = 13 patients), double transplant followed by recombinant alpha interferon (IFN) (Group III = 17 patients). The actuarial median duration of second chronic phase was 3 months, 10 months and 18 months for Group I, Group II and Group III patients (p less than 0.0001). The encouraging results observed for Group III patients prompted us to propose ABSCT for patients in chronic phase with initial prognostic factors (high-risk CML) suggesting that IFN will not be effective if administered as front-line therapy. To date, 13 patients with high-risk CML underwent ABSCT followed by IFN therapy. Ten patients achieved a complete hematological response following transplantation. Two of 6 evaluable patients had a cytogenetical response 6 months after ABSCT. A longer follow-up is needed to see if the duration of chronic phase may be prolonged.
47例处于转化期的Ph1阳性慢性粒细胞白血病（CML）患者在初次诊断且未接受任何治疗前接受了外周血干细胞自体移植（ABSCT）。他们按照3种连续的策略进行治疗：单次移植（I组=17例患者）、两次移植（II组=13例患者）、两次移植后给予重组α干扰素（IFN）（III组=17例患者）。I组、II组和III组患者第二次慢性期的精算中位持续时间分别为3个月、10个月和18个月（p<0.0001）。III组患者观察到的令人鼓舞的结果促使我们建议对处于慢性期且具有初始预后因素（高危CML）的患者进行ABSCT，这些因素表明如果将IFN作为一线治疗，其效果不佳。迄今为止，13例高危CML患者接受了ABSCT，随后接受IFN治疗。10例患者移植后获得了完全血液学缓解。6例可评估患者中有2例在ABSCT后6个月出现细胞遗传学缓解。需要更长时间的随访来观察慢性期的持续时间是否可能延长。
