Valteau D, Hartmann O, Benhamou E, Caillaud J M, Brugières L, Beaujean F, Patte C, Flamant F, Lemerle J
Département de Pédiatrie, Institut Gustave-Roussy, Villejuif, France.
Transplantation. 1988 Apr;45(4):737-40. doi: 10.1097/00007890-198804000-00014.
Between February 1979 and May 1986, 165 children were treated with autologous bone marrow transplantation after high-dose chemotherapy without total-body irradiation for a hematologic malignancy or a solid tumor. Nonbacterial nonfungal interstitial pneumonitis was observed in 24 children and was the cause of death in 11 cases. Of the 24 cases of interstitial pneumonitis, 14 were considered to be idiopathic. Cytomegalovirus was the major pathogenic agent detected in the 10 other cases of interstitial pneumonitis (n = 5), followed by Herpes zoster (n = 2), Pneumocystis carinii (n = 1), tumor (n = 1), and adenovirus (n = 1). The only factor found to correlate significantly with the increased rate of interstitial pneumonitis was the use of high-dose 1-3 bis chloroethyl-1 nitrosourea (BCNU) (600 mg/m2), whereas BCNU at a dose of 300 mg/m2 did not affect this rate. These data, when compared with the literature, show a lower incidence of interstitial pneumonitis than in allogeneic transplantations, and an incidence similar to that observed in syngeneic transplantations, although there was no radiation toxicity in this series.
1979年2月至1986年5月期间，165名儿童在接受高剂量化疗但未进行全身照射后接受了自体骨髓移植，用于治疗血液系统恶性肿瘤或实体瘤。24名儿童出现了非细菌性非真菌性间质性肺炎，其中11例死亡。在24例间质性肺炎病例中，14例被认为是特发性的。在其他10例间质性肺炎病例中检测到的主要病原体是巨细胞病毒（n = 5），其次是带状疱疹（n = 2）、卡氏肺孢子虫（n = 1）、肿瘤（n = 1）和腺病毒（n = 1）。唯一与间质性肺炎发生率增加显著相关的因素是使用高剂量的1-3双氯乙基-1亚硝基脲（BCNU）（600 mg/m2），而剂量为300 mg/m2的BCNU对该发生率没有影响。与文献相比，这些数据显示间质性肺炎的发生率低于同种异体移植，与同基因移植中观察到的发生率相似，尽管该系列中没有放射毒性。
