Inoue T, Masaoka T
Gan To Kagaku Ryoho. 1986 Apr;13(4 Pt 1):911-21.
The records of 225 patients with leukemia and 25 patients with malignant lymphoma who underwent bone marrow transplantation (BMT) from 1975 through June 1985 were collected by national survey in Japan. For acute leukemia patients, one-year survivals by year of BMT were 8%, 46% and 56% for groups I (-1980), II (-June, 1983) and III (-June, 1985), respectively. The corresponding one-year probabilities of developing interstitial pneumonia were 93%, 45% and 27%, respectively. Survivals after BMT in the first remission in ALL and ANL patients as well as in the chronic phase in CML were better than in the remaining conditions. On the basis of the high relapse rate in syngeneic BMT for acute leukemia, it was indicated that a more aggressive treatment schedule would be necessary before and after transplantation. Despite extensive disease in cases of malignant lymphoma (all clinical stages III and IV), 5-year survival was 36%. The present analysis indicated that changes in the selection of patients, e.g., those in the first remission without infection at the time of BMT, as well as low dose-rate fractionated TBI and selection of platelet donors with negative CMV titer, had resulted in a significant improvement of survival and a decreased incidence of interstitial pneumonia after BMT for leukemia in Japan.
通过日本全国性调查收集了1975年至1985年6月期间接受骨髓移植（BMT）的225例白血病患者和25例恶性淋巴瘤患者的记录。对于急性白血病患者，I组（-1980年）、II组（-1983年6月）和III组（-1985年6月）的BMT后一年生存率分别为8%、46%和56%。相应的发生间质性肺炎的一年概率分别为93%、45%和27%。急性淋巴细胞白血病（ALL）和急性非淋巴细胞白血病（ANL）患者首次缓解期以及慢性粒细胞白血病（CML）慢性期BMT后的生存率高于其余情况。基于急性白血病同基因BMT的高复发率，表明移植前后需要更积极的治疗方案。尽管恶性淋巴瘤患者病情广泛（所有临床分期为III期和IV期），5年生存率仍为36%。目前的分析表明，患者选择的改变，例如BMT时处于首次缓解且无感染的患者，以及低剂量率分次全身照射（TBI）和选择巨细胞病毒（CMV）滴度阴性的血小板供体，已使日本白血病患者BMT后的生存率显著提高，间质性肺炎的发生率降低。
