Santos G W, Yeager A M, Jones R J
Oncology Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Annu Rev Med. 1989;40:99-112. doi: 10.1146/annurev.me.40.020189.000531.
Autologous bone marrow transplantation in the acute leukemias and lymphomas offers potentially curative treatment in patients who do not have a histocompatible, allogeneic donor. Results of marrow autografting in the lymphomas are especially encouraging, with disease-free survivals of 50-60% in patients who have failed primary and secondary treatment regimens. In the acute leukemias, one may expect 20-40% relapse-free survival after autologous marrow transplantation. We feel that ex vivo treatment ("purging") is necessary to eradicate occult tumor cells from autologous remission marrow in hematological malignancies, but this remains a controversial issue to some investigators. Preliminary studies of autologous bone marrow transplantation are promising in multiple myeloma and certain childhood tumors, and autografting is currently being explored in the treatment of other solid tumors such as adenocarcinoma of the breast.
对于没有组织相容性全相合供体的急性白血病和淋巴瘤患者，自体骨髓移植提供了潜在的治愈性治疗方法。淋巴瘤患者骨髓自体移植的结果尤其令人鼓舞，对于一线和二线治疗方案失败的患者，无病生存率可达50%-60%。在急性白血病中，自体骨髓移植后预计无复发生存率为20%-40%。我们认为，体外处理（“净化”）对于清除血液系统恶性肿瘤患者自体缓解骨髓中的隐匿肿瘤细胞是必要的，但这对一些研究者来说仍是一个有争议的问题。自体骨髓移植的初步研究在多发性骨髓瘤和某些儿童肿瘤中很有前景，目前正在探索自体移植治疗其他实体瘤，如乳腺癌。
