Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Biol Blood Marrow Transplant. 2013 Mar;19(3):344-56. doi: 10.1016/j.bbmt.2012.08.011. Epub 2012 Aug 24.
Melphalan remains the most widely used agent in preparative regimens for hematopoietic stem cell transplantation (SCT). From its initial discovery more than 50 years ago, it has been gradually incorporated in the conditioning regimens for both autologous and allogeneic transplantations because of its myeloablative properties and broad antitumor effects as a DNA alkylating agent. Melphalan remains the mainstay conditioning for multiple myeloma and lymphomas, and it has been used successfully in preparative regimens of a variety of other hematological and nonhematological malignancies. The addition of newer agents to conditioning, such as bortezomib or lenalidomide for myeloma or clofarabine for myeloid malignancies, may improve antitumor effects for transplantation, whereas melphalan in combination with alemtuzumab may represent a backbone for future cellular therapy because of reliable engraftment and low toxicity profile. This review summarizes the development and the current use of this remarkable drug in hematopoietic SCT.
美法仑仍然是造血干细胞移植 (SCT) 中最广泛使用的预备方案药物。自 50 多年前首次发现以来，由于其具有骨髓清除特性和作为 DNA 烷化剂的广泛抗肿瘤作用，它已逐渐被纳入自体和同种异体移植的预处理方案中。美法仑仍然是多发性骨髓瘤和淋巴瘤的主要预处理药物，并且已成功用于多种其他血液系统和非血液系统恶性肿瘤的预备方案中。在预处理中添加新的药物，如硼替佐米或来那度胺用于骨髓瘤，或克拉屈滨用于髓样恶性肿瘤，可能会提高移植的抗肿瘤效果，而美法仑与阿仑单抗联合使用可能代表未来细胞治疗的骨干，因为它具有可靠的植入和低毒性特征。这篇综述总结了这种非凡药物在造血 SCT 中的发展和当前应用。
