Koeppler H, Pflueger K H, Wolf M, Weide R, Havemann K
Department of Internal Medicine, Philipps-University, Marburg, FRG.
Haematol Blood Transfus. 1990;33:699-701. doi: 10.1007/978-3-642-74643-7_127.
Seven patients with acute myeloid leukemia (AML) in first complete remission were treated with escalating high doses of cyclophosphamide, etoposide, and cytosine arabinoside (Ara-C). In all patients autologous bone marrow preservation was performed prior to therapy. Bone marrow was stored in blood bags in a refrigerator for 48-72 h at 4 degrees C and then reinfused over a central line. All patients had a full hematological recovery. The mean time of neutropenia (neutrophils less than 500/microliters) was 14 days (range 9-24 days), and the mean time of thrombocytopenia (platelets less than 20,000/microliters) was 9 days (range 7-11 days). The nonhematological toxicity was tolerable with mild to moderate nausea/vomiting, mucositis and diarrhea, and so far not dose-limiting. Six patients remain in complete remission 17+, 9+, 5+, 5+, 4+, and 1+ months after autotransplantation. One patient relapsed 8 months after autotransplantation. High-dose chemotherapy with noncryopreserved bone marrow autotransplantation may be useful as intensified consolidation for patients with AML in first complete remission.
7例首次完全缓解的急性髓系白血病（AML）患者接受了递增剂量的环磷酰胺、依托泊苷和阿糖胞苷（Ara-C）治疗。所有患者在治疗前均进行了自体骨髓保存。骨髓保存在血袋中，于4℃冰箱中存放48 - 72小时，然后通过中心静脉导管回输。所有患者均实现了完全血液学缓解。中性粒细胞减少（中性粒细胞低于500/微升）的平均时间为14天（范围9 - 24天），血小板减少（血小板低于20,000/微升）的平均时间为9天（范围7 - 11天）。非血液学毒性可耐受，表现为轻至中度恶心/呕吐、黏膜炎和腹泻，目前尚未达到剂量限制。6例患者在自体移植后17 +、9 +、5 +、5 +、4 +和1 +个月仍处于完全缓解状态。1例患者在自体移植后8个月复发。非冷冻保存骨髓自体移植的大剂量化疗对于首次完全缓解的AML患者作为强化巩固治疗可能有效。
