Vossen J M, van Leeuwen E F, van 't Veer-Korthof E T, Slaper-Cortenbach C M, van den Berg H, Gerritsen E J, Hermans J, Weening R S
Vakgroep Kindergeneeskunde, Rijksuniversiteit Leiden.
Tijdschr Kindergeneeskd. 1988 Apr;56(2):73-82.
Bone marrow transplantation (BMT) is an intensive mode of treatment for acute leukemia of childhood. Indication are types and stages of leukemia with a poor prognosis following chemotherapy, such as acute nonlymphocytic leukemia (ANLL) in first complete remission (CR) of the disease, and acute lymphocytic leukemia (ALL) following relapse of the disease, in second CR. On the basis of our own experience and of analysis of published data it can be stated that allogeneic BMT, grafting bone marrow cells from a healthy HLA-identical sibling of the patient, has a long-term therapeutical effect which is superior to that of chemotherapy alone: in cases of ANLL, grafted in first CR, a long-term disease-free survival of 55 to 67% was obtained, and in cases of ALL, grafted in second CR, this was between 38 and 64%. The potential effect of autologous BMT, i.e. with own bone marrow of the patient, sampled during CR of the disease, cannot yet be evaluated properly, because the follow-up period of this mode of treatment is too short. It is worth while to investigate the potential beneficial effect of autologous BMT, e.g. for children with ALL in second CR, who lack a HLA-identical donor. Also the potential contribution of bone marrow purging, e.g. for CALLA-positive lymphocytes, should be investigated in relation to the relapse risk after autologous BMT for common ALL.
骨髓移植（BMT）是治疗儿童急性白血病的一种强化治疗方式。其适应症为化疗后预后较差的白血病类型和阶段，如疾病首次完全缓解（CR）期的急性非淋巴细胞白血病（ANLL），以及疾病复发后第二次CR期的急性淋巴细胞白血病（ALL）。根据我们自己的经验以及对已发表数据的分析，可以说同种异体BMT，即移植患者健康的 HLA 匹配同胞的骨髓细胞，具有优于单纯化疗的长期治疗效果：对于在首次CR期进行移植的ANLL患者，长期无病生存率为55%至67%；对于在第二次CR期进行移植的ALL患者，这一比例在38%至64%之间。自体BMT的潜在效果，即使用患者在疾病CR期采集的自身骨髓，目前尚无法得到恰当评估，因为这种治疗方式的随访期太短。值得研究自体BMT的潜在有益效果，例如对于缺乏 HLA 匹配供体的第二次CR期ALL患儿。此外，还应研究骨髓净化（例如针对 CALLA 阳性淋巴细胞）对普通ALL自体BMT后复发风险的潜在影响。
