Anderson K C, Barut B A, Ritz J, Freedman A S, Nadler L M
Eur J Haematol Suppl. 1989;51:157-63. doi: 10.1111/j.1600-0609.1989.tb01510.x.
We have begun an autologous bone marrow transplantation (ABMT) treatment protocol for patients with myeloma who achieve a minimal disease (less than 10% marrow plasma cells) status. Sites of bony disease are irradiated before BMT. Melphalan 70 mg/m2 on days 1 and 2 is followed by 1200 rads total-body irradiation administered in fractionated doses over 3 d. Autologous marrow which has been previously treated with anti-CALLA, B1, and PCA-1 monoclonal antibodies is then thawed and reinfused. 4 males and 2 females with median age of 46 yr (41-56) have been treated. Granulocytes greater than 500/mm3 and platelets greater than 20,000/mm3 were noted at 21 (12-46) and 23 (12-53) d post-transplant (PT), respectively. Acute mucositis and dermatomal Herpes zoster developed in 3 patients each; all patients are clinically well at 233 (30-807) d PT. All patients achieved pathologically normal marrows, but monoclonal plasma cells and marrow myelofibrosis were each noted in a single patient at 486 and 272 d PT, respectively. A single patient has responded to alpha 2 interferon therapy PT; all others have received no therapy. AMBT offers an exciting new treatment for myeloma; however, relapses post-ABMT suggest that improved ablative regimens and/or marrow purging methods may be required.
我们已开始对达到微小疾病（骨髓浆细胞少于10%）状态的骨髓瘤患者实施自体骨髓移植（ABMT）治疗方案。在进行骨髓移植前，对骨病部位进行照射。第1天和第2天给予马法兰70mg/m²，随后在3天内分剂量给予1200拉德的全身照射。然后将先前用抗CALLA、B1和PCA-1单克隆抗体处理过的自体骨髓解冻并回输。已治疗4名男性和2名女性，中位年龄为46岁（41 - 56岁）。移植后（PT）21天（12 - 46天）和23天（12 - 53天）时分别观察到粒细胞大于500/mm³和血小板大于20,000/mm³。3名患者发生急性粘膜炎，3名患者发生带状疱疹；所有患者在PT 233天（30 - 807天）时临床状况良好。所有患者骨髓病理均恢复正常，但分别在PT 486天和272天时，有1名患者发现单克隆浆细胞，1名患者发现骨髓髓样化生。1名患者PT后对α2干扰素治疗有反应；其他患者均未接受治疗。自体骨髓移植为骨髓瘤提供了一种令人兴奋的新治疗方法；然而，自体骨髓移植后的复发提示可能需要改进预处理方案和/或骨髓净化方法。
