Speck B, Cornu P, Jeannet M, Sartorius J, Nissen C, Groff P, Burri H P
Schweiz Med Wochenschr. 1977 Oct 15;107(41):1451-2.
23 patients with severe aplastic anemia have been treated. 10 marrow grafts between HLA matched siblings were performed after conditioning with cyclophosphamide. 5 are still alive at over 7 months to over 2 1/2 years after grafting. 3 are hemopoietic chimeras and 2 show autologous marrow reconstitution. 13 patients were treated by ALG with or without transfusion of allogeneic marrow. 9 are still alive with partial to complete autologous hemopoietic reconstitution at over 1 month to over 4 years. It is concluded that in many instances aplastic anemia is an autoimmune disease rather than a primary failure of the hemopoietic stem cells. In acute leukemia allogeneic marrow grafts still pose enormous problems and only one of our 12 grafts has become a longterm survivor.
23例严重再生障碍性贫血患者接受了治疗。10例患者在接受环磷酰胺预处理后,进行了HLA配型相合的同胞间骨髓移植。5例在移植后7个月至2年半以上仍存活。3例为造血嵌合体,2例显示自体骨髓重建。13例患者接受了抗淋巴细胞球蛋白治疗,部分患者还输注了同种异体骨髓。9例在1个月至4年以上仍存活,伴有部分至完全的自体造血重建。得出的结论是,在许多情况下,再生障碍性贫血是一种自身免疫性疾病,而非造血干细胞的原发性衰竭。在急性白血病中,同种异体骨髓移植仍然存在巨大问题,我们的12例移植患者中只有1例成为长期存活者。