Dicke K A, Jagannath S, Walters R S, Horwitz L J, Spitzer G
Department of Hematology, University of Texas System Cancer Center, M.D. Anderson Hospital & Tumor Institute, Houston 77030.
Ann N Y Acad Sci. 1987;511:468-72. doi: 10.1111/j.1749-6632.1987.tb36278.x.
One hundred and twenty-seven patients with acute leukemia were treated with high-dose cytoreductive programs in conjunction with autologous marrow. Transplantation in relapse resulted in a complete remission rate ranging from 33% to 72%, depending on the time of transplantation, the conditioning regimen used and the performance status of the patient. Remission duration was short, ranging from three to nine months. Transplantation in second or subsequent remission did not change the natural history of the disease. In 14% of the cases, transplantation remissions were obtained exceeding the duration of the preceding remission, results equivalent to those obtained by normal dose chemotherapy. Transplantation in first remission (CR1) resulted in a projected two-year disease-free survival of 72% (13% SE) in acute myelogenous leukemia and of 45% (17% SE) in acute lymphocytic leukemia. We conclude from these data that the results look promising in CR1 and that in second and subsequent remissions a realistic study design is possible by which the influence on the natural history of disease by changing the bone marrow transplantation program, such as purging in vitro, can be studied.
127例急性白血病患者接受了大剂量细胞减灭方案联合自体骨髓治疗。复发时进行移植，完全缓解率在33%至72%之间，这取决于移植时间、所采用的预处理方案以及患者的身体状况。缓解期较短，为三至九个月。第二次或后续缓解期进行移植并未改变疾病的自然病程。在14%的病例中，移植后获得的缓解期超过了前次缓解期，结果与常规剂量化疗相当。首次缓解期（CR1）进行移植，急性髓性白血病预计两年无病生存率为72%（标准误差13%），急性淋巴细胞白血病为45%（标准误差17%）。我们从这些数据得出结论，CR1期的结果看起来很有希望，并且在第二次及后续缓解期，可以进行一项现实可行的研究设计，通过该设计可以研究改变骨髓移植方案（如体外净化）对疾病自然病程的影响。
