Mayer R J
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115.
Bone Marrow Transplant. 1990 Jul;6 Suppl 1:48-51.
At present, using the most contemporary management techniques, it would appear that allogeneic bone marrow transplantation and intensive chemotherapy offer a roughly equivalent potential for curing adult patients with AML in first remission. Each form of treatment has drawbacks--the limited eligibility and continued high rate of early death associated with the allogeneic transplant procedure and the significantly greater likelihood of relapse, as well as the risk for drug-induced, life-threatening toxicities observed following the administration of chemotherapy. Future efforts should be directed at improving each of these treatment techniques, perhaps through kinetic synchronization of leukemic cells by hematopoietic growth factors to make chemotherapy more potent and by better understanding and then harnessing the "graft-versus-leukemia" effect which appears so instrumental in reducing the relapse rate following allografting.
目前，采用最现代的管理技术来看，异基因骨髓移植和强化化疗在治愈首次缓解期的成年急性髓系白血病（AML）患者方面似乎具有大致相同的潜力。每种治疗方式都有缺点——异基因移植手术的合格者有限且早期死亡率持续居高不下，以及化疗后复发的可能性显著更高，还有化疗给药后出现药物诱导的危及生命毒性的风险。未来的努力应致力于改进这些治疗技术中的每一种，或许可通过造血生长因子使白血病细胞动力学同步，以使化疗更有效，并通过更好地理解并利用“移植物抗白血病”效应，这种效应在降低同种异体移植后的复发率方面似乎至关重要。
