Arnold R, Heimpel H
Dept. Internal Medicine III, University of Ulm, F.R.G.
Bone Marrow Transplant. 1989 Dec;4 Suppl 4:101-3.
In the literature 63 patients with myelodysplastic syndromes (MDS) are reported who were treated with syngeneic or allogeneic bone marrow transplantation. 62 patients were prepared for BMT with TBI containing regimens or Busulfan/Cyclophosphamide. GvHD prophylaxis was heterogenous. 33/63 patients are alive and well between 4 and 132 months after BMT. 23/63 patients died due to GvHD (n = 6), interstitial pneumonitis (n = 6), other infections (n = 4), toxicity of the preparative regimen (n = 5) or graft failure (n = 2). 9/63 patients relapsed between 2 and 98 (in median 6) months after BMT. There seems to be a correlation between the subtype of the MDS and the relapse rate: only 1/18 patients with RA/RARS relapsed compared to 7/42 patients with RAEB/RAEB-T. These results indicate that marrow transplantation can induce long term survival and may result in cure of patients with MDS.
文献报道了63例接受同基因或异基因骨髓移植治疗的骨髓增生异常综合征(MDS)患者。62例患者采用含全身照射(TBI)的方案或白消安/环磷酰胺进行骨髓移植预处理。移植物抗宿主病(GvHD)的预防措施各异。33/63例患者在骨髓移植后4至132个月存活且状况良好。23/63例患者死于移植物抗宿主病(n = 6)、间质性肺炎(n = 6)、其他感染(n = 4)、预处理方案的毒性(n = 5)或移植失败(n = 2)。9/63例患者在骨髓移植后2至98(中位数6)个月复发。MDS的亚型与复发率之间似乎存在相关性:仅1/18例难治性贫血/难治性贫血伴环形铁粒幼细胞增多(RA/RARS)患者复发,而难治性贫血伴原始细胞过多/转化中的难治性贫血伴原始细胞过多(RAEB/RAEB-T)患者中有7/42例复发。这些结果表明,骨髓移植可诱导长期生存,并可能治愈MDS患者。