Bortin M M, Rimm A A
JAMA. 1978 Sep 15;240(12):1245-52.
Fifty-seven patients with end-stage acute myeloblastic leukemia (AML) received a total of 65 bone marrow transplants between 1968 and 1976. Marrow from HLA genotypically identical allogeneic donors was administered to 32 patients, 13 received marrow from HLA-incompatible donors, donor-recipient HLA compatibility was undetermined for eight patients, and identical twins were marrow donors for four patients. None of the patients in the three latter groups survived beyond 9.4 months after transplantation. Two patients treated with marrow transplants from HLA-compatible donors currently are alive and free of leukemia with functioning grafts 13 and 38 months after transplantation. The 32 patients in the Registry series who received marrow from HLA-compatible donors were compared with a similar series of 46 patients in Seattle. Data for these 78 patients were pooled and analyzed for pretransplant factors that might have prognostic value. Patients with end-stage AML had approximately a 10% chance of surviving 20 months after high-dose chemoradiotherapy plus marrow transplantation. Patients younger than 21 years had a higher six-month survival rate than patients older than 30 years. Patients in the Registry series who received transplants with HLA-compatible marrow within eight months of diagnosis had a higher survival experience than patients who received transplants later.
1968年至1976年间，57例终末期急性髓细胞白血病（AML）患者共接受了65次骨髓移植。32例患者接受了来自HLA基因分型相同的同种异体供者的骨髓，13例接受了来自HLA不相合供者的骨髓，8例患者供受者HLA相容性未确定，4例患者的同卵双胞胎为骨髓供者。后三组中的患者无一在移植后存活超过9.4个月。两名接受HLA相合供者骨髓移植治疗的患者目前仍存活，移植后13个月和38个月时白血病未复发且移植物功能良好。将登记系列中接受HLA相合供者骨髓的32例患者与西雅图的46例类似患者进行比较。汇总这78例患者的数据，并分析可能具有预后价值的移植前因素。终末期AML患者在大剂量放化疗加骨髓移植后存活20个月的几率约为10%。21岁以下患者的六个月生存率高于30岁以上患者。登记系列中在诊断后八个月内接受HLA相合骨髓移植的患者比晚些时候接受移植的患者有更高的生存几率。
