Meloni G, De Fabritiis P, Alimena G, Malagnino F, Montefusco E, Sandrelli A, Pinto R, Vignetti M, Lo Coco F, Mandelli F
University La Sapienza, Rome, Italy.
Bone Marrow Transplant. 1989 Dec;4 Suppl 4:92-4.
The progressive and fatal course of chronic myelogenous leukemia has not been affected significantly by chemotherapeutic agents that control the benign phase of the disease. Combination chemotherapy and aggressive treatments may offer some advantages: however, these approaches do not appear to produce stable suppression of Ph1 chromosome or to prolong chronic phase and survival of these patients. Only allogeneic bone marrow transplantation has been demonstrated to be capable of inducing a stable, complete suppression of Ph1+ cells. Recently alpha Interferons (IFN) have been shown to control myeloid proliferation in patients with CML and to determine a progressive and persistent decline of Ph1+ bone marrow cells in some cases. The hypothesis that in most newly diagnosed patients with CML various amount of Ph1 negative cells must still be present, albeit in suppressed state in the bone marrow (BM) or in the peripheral blood (PB), have led some Authors to treat patients with high-dose chemotherapy followed by reinfusion of stem cells collected at diagnosis or after a response to cytoreductive treatments. We report 34 patients with CML treated in chronic phase with Busulohan and Melphalan conditioning regimen followed by reinfusion of BM or PB stem cells.
控制慢性粒细胞白血病良性期的化疗药物，并未显著影响该病的进展性及致命病程。联合化疗和积极治疗或许有一些优势：然而，这些方法似乎无法稳定抑制Ph1染色体，也不能延长这些患者的慢性期及生存期。只有异基因骨髓移植已被证明能够诱导稳定、完全地抑制Ph1+细胞。最近，α干扰素（IFN）已被证明可控制慢性粒细胞白血病患者的髓系增殖，并在某些情况下使Ph1+骨髓细胞逐步且持续减少。有假说认为，在大多数新诊断的慢性粒细胞白血病患者中，尽管骨髓（BM）或外周血（PB）中的Ph1阴性细胞处于受抑制状态，但仍必定存在不同数量的此类细胞，这使得一些作者采用大剂量化疗，随后回输在诊断时或对细胞减灭治疗产生反应后采集的干细胞来治疗患者。我们报告了34例慢性期慢性粒细胞白血病患者，采用白消安和马法兰预处理方案，随后回输骨髓或外周血干细胞进行治疗。
