Nemet D, Labar B, Bogdanić V, Kolevska T, Mrsić M, Pavletić Z, Kalenić S, Vrtar M, Marusić M, Markulin-Grgić L
Lijec Vjesn. 1989 Sep-Oct;111(9-10):348-53.
Autologous bone marrow transplantation (ABMT) allows application of intensive myeloablative therapy aimed at eradication of neoplastic disease by facilitating haematopoietic reconstitution. Between March and June 1988, four patients (two with acute myelogenous leukaemia in first remission, one with acute lymphoblastic leukaemia in second remission, and one with Burkitt lymphoma, stage IV with CNS involvement in second remission) received this treatment. Methods of collecting, processing and freezing bone marrow as well as thawing and reinfusion of the marrow into patients after intensive chemoradiotherapy are described. Viability of bone marrow cells tested by the dye exclusion method after freezing and thawing process was 89, 88, 91 and 78%, respectively. CFU-GM recovery in culture, as a test of marrow stem cells clonogenicity was between 63,3 and 156,5%. Patients received between 1,7 and 3,0 x 10(8)/kg nucleated cells and 4,0 to 7,6 x 10(4)/kg CFU-GM, respectively. In all four patients stable haematopoietic reconstitution was achieved. The bone marrow function was evident mainly at 11th day after marrow reinfusion. Leukocyte count reached 1,0 x 10(0)/L in 11 to 15 days, and granulocyte count raised more than 0,5 x 10(9)/L in 19 to 37 days after transplantation. Platelet recovery was prolonged with the minimum of 29 days and maximum of more than 60 days to reach 20 x 10(9)/L. Side effects caused by the intensive radiochemotherapy were moderate. Bacterial, fungal and viral infections in early posttransplant period were successfully treated. All patients have survived and left the hospital 63, 54, 36 and 65 days after ABMT, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
自体骨髓移植(ABMT)通过促进造血重建,使得针对根除肿瘤性疾病的强化清髓疗法得以应用。1988年3月至6月期间,4例患者(2例首次缓解的急性髓性白血病患者、1例第二次缓解的急性淋巴细胞白血病患者以及1例处于第二次缓解且伴有中枢神经系统受累的IV期伯基特淋巴瘤患者)接受了该治疗。本文描述了骨髓的采集、处理和冷冻方法,以及在强化放化疗后将骨髓解冻并回输至患者体内的过程。经冷冻和解冻过程后,采用染料排斥法检测骨髓细胞的活力,分别为89%、88%、91%和78%。作为骨髓干细胞克隆形成能力检测指标的培养中CFU-GM回收率在63.3%至156.5%之间。患者分别接受了1.7至3.0×10⁸/kg有核细胞和4.0至7.6×10⁴/kg CFU-GM。所有4例患者均实现了稳定的造血重建。骨髓功能主要在骨髓回输后第11天显现。白细胞计数在移植后11至15天达到1.0×10⁹/L,粒细胞计数在移植后19至37天升高超过0.5×10⁹/L。血小板恢复时间延长,最短29天,最长超过60天达到20×10⁹/L。强化放化疗引起的副作用较为中度。移植后早期的细菌、真菌和病毒感染均得到成功治疗。所有患者均存活,并分别在自体骨髓移植后63天、54天、36天和65天出院。(摘要截选至250字)