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[自体骨髓移植——肿瘤血液疾病治疗的新方法。II. 急性白血病、恶性淋巴瘤和实体瘤的临床结果]

[Transplantation of autologous bone marrow--a new approach in the treatment of neoplastic hematologic diseases. II. Clinical results in acute leukemia, malignant lymphoma and solid tumors].

作者信息

Nemet D

机构信息

Zavod za hematologiju, Klinika za unutarnje bolesti s poliklinikom, Klinicki bolnicki centar, Medicinski fakultet Sveucilista u Zagrebu.

出版信息

Lijec Vjesn. 1990 Jan-Feb;112(1-2):53-8.

PMID:2366622
Abstract

In this second part of the review the clinical significance of autologous bone marrow transplantation (ABMT) as treatment for acute leukemias (AL) and malignant lymphomas is described. In most adult patients with AL in complete remission treated with conventional maintenance therapy relapse usually occurs within one year. However, the results of ABMT, as an intensive consolidation treatment in patients with AL in remission show long-term disease-free survival in a proportion of 40% of patients. Even better results have been reported in patients with purged bone marrow, although the difference is not statistically significant. A major problem of ABMT is still the high percentage of relapse (50%), while the probability of treatment related mortality is relatively low (up to 10%). ABMT is also showing good results in the treatment of non-Hodgkin's lymphomas of intermediate and high-grade histology and in Hodgkin's disease in cases refractory to the first line therapy and in sensitive relapse. However, in refractory cases the results are poor. It is noteworthy, that in all disorders treated with ABMT, prospective randomised controlled trials are missing and current data are based on heterogenous groups of patients. In the majority of solid tumors, even escalated doses of radiochemotherapy with ABMT are not able to eradicate malignant disease. In contrast, the results are very good in neuroblastoma. Although ABMT is a relatively complex and aggressive method, it is being increasingly applied to the treatment of haematological malignant diseases and the results obtained so far, are encouraging and showing that ABMT, besides allogeneic BMT, represents a promising potentially curative treatment for selected group of patients.

摘要

在本综述的第二部分,描述了自体骨髓移植(ABMT)作为急性白血病(AL)和恶性淋巴瘤治疗方法的临床意义。在大多数接受传统维持治疗且处于完全缓解期的成年AL患者中,复发通常在一年内发生。然而,ABMT作为缓解期AL患者的强化巩固治疗方法,有40%的患者实现了长期无病生存。对于经过净化骨髓的患者,报告的结果更好,尽管差异无统计学意义。ABMT的一个主要问题仍然是高复发率(50%),而治疗相关死亡率相对较低(高达10%)。ABMT在治疗中高分级组织学的非霍奇金淋巴瘤以及一线治疗难治或敏感复发的霍奇金病方面也显示出良好效果。然而,在难治性病例中结果较差。值得注意的是,在所有接受ABMT治疗的疾病中,缺乏前瞻性随机对照试验,目前的数据基于异质性患者群体。在大多数实体瘤中,即使联合ABMT增加放化疗剂量也无法根除恶性疾病。相比之下,神经母细胞瘤的治疗结果非常好。尽管ABMT是一种相对复杂且激进的方法,但它正越来越多地应用于血液系统恶性疾病的治疗,目前所取得的结果令人鼓舞,表明ABMT除了异基因骨髓移植外,对特定患者群体而言是一种有前景的潜在治愈性治疗方法。

相似文献

1
[Transplantation of autologous bone marrow--a new approach in the treatment of neoplastic hematologic diseases. II. Clinical results in acute leukemia, malignant lymphoma and solid tumors].[自体骨髓移植——肿瘤血液疾病治疗的新方法。II. 急性白血病、恶性淋巴瘤和实体瘤的临床结果]
Lijec Vjesn. 1990 Jan-Feb;112(1-2):53-8.
2
Autologous bone marrow transplantation in the treatment of malignant lymphoma and Hodgkin's disease.自体骨髓移植治疗恶性淋巴瘤和霍奇金病。
Semin Hematol. 1988 Apr;25(2 Suppl 2):58-65.
3
Autologous bone marrow transplantation in acute leukemia.急性白血病的自体骨髓移植
J Natl Cancer Inst. 1986 Jun;76(6):1281-7.
4
Treatment of relapsed aggressive lymphomas: regimens with and without high-dose therapy and stem cell rescue.复发侵袭性淋巴瘤的治疗:含与不含高剂量治疗及干细胞救援的方案
Cancer Chemother Pharmacol. 2002 May;49 Suppl 1:S13-20. doi: 10.1007/s00280-002-0447-1. Epub 2002 Apr 12.
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Outcome assessment of age group-specific (+/- 50 years) post-remission consolidation with high-dose cytarabine or bone marrow autograft for adult acute myelogenous leukemia.针对成人急性髓性白血病,采用大剂量阿糖胞苷或自体骨髓移植进行特定年龄组(±50岁)缓解后巩固治疗的疗效评估。
Haematologica. 1998 Jul;83(7):627-35.
6
[The role of autologous bone marrow transplantation in cancer treatment].[自体骨髓移植在癌症治疗中的作用]
Gan To Kagaku Ryoho. 1987 Nov;14(11):2989-97.
7
[Allogenic bone marrow transplantation versus autograft in acute lymphoblastic leukemia, in second remission in 113 children. Results of the Grupo Español de Transplante de Medula Niños (GETMON)].[113名处于第二次缓解期的儿童急性淋巴细胞白血病患者接受异基因骨髓移植与自体移植的对比研究。西班牙儿童骨髓移植协作组(GETMON)的研究结果]
Sangre (Barc). 1996 Apr;41(2):101-8.
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New conditioning regimens for high risk marrow transplants.
Bone Marrow Transplant. 1989 Dec;4 Suppl 4:15-7.
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Autologous bone marrow transplantation for haematological malignancies--experiences of the centre of Zagreb.血液系统恶性肿瘤的自体骨髓移植——萨格勒布中心的经验
Wien Med Wochenschr. 1995;145(2-3):61-4.
10
Increasing incidence of late second malignancies after conditioning with cyclophosphamide and total-body irradiation and autologous bone marrow transplantation for non-Hodgkin's lymphoma.对于非霍奇金淋巴瘤,在接受环磷酰胺和全身照射预处理及自体骨髓移植后,晚期第二原发恶性肿瘤的发病率不断上升。
J Clin Oncol. 2005 Apr 1;23(10):2208-14. doi: 10.1200/JCO.2005.05.158. Epub 2005 Mar 7.

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