Stewart P, Buckner C D, Bensinger W, Appelbaum F, Fefer A, Clift R, Storb R, Sanders J, Meyers J, Hill R
Exp Hematol. 1985 May;13(4):267-72.
Thirteen patients with acute nonlymphocytic leukemia underwent autologous bone marrow transplantation (ABMT) following high doses of cyclophosphamide and total body irradiation while in first complete remission. After marrow infusion four patients received human leukocyte interferon and nine received intravenous methotrexate. One patient died on day 16 of septicemia associated with severe gastrointestinal toxicity. In the remaining 12 patients the median day of achieving a circulating granulocyte level of 500/mm3 was 29 (range 15-94 days). Eight of 12 evaluable patients achieved a sustained platelet count of 20,000/mm3 or greater in a median of 44 days (range 12-116 days) and four patients did not achieve this level before death on days 116-396. One patient died on day 116 of interstitial pneumonitis secondary to cytomegalovirus. Eight patients relapsed 58-365 days after AMBT (median 335 days), and all have died. Three patients are alive and well without relapse 26-50 months after ABMT. This study demonstrated that poor engraftment was a frequent complication of ABMT when early posttransplant cytotoxic therapy was attempted. Relapse of leukemia and the number of long-term survivors in this small group of patients was not different from that expected following conventional therapy.
13例急性非淋巴细胞白血病患者在首次完全缓解期接受了大剂量环磷酰胺和全身照射后进行自体骨髓移植（ABMT）。骨髓输注后，4例患者接受了人白细胞干扰素治疗，9例患者接受了静脉甲氨蝶呤治疗。1例患者在第16天死于与严重胃肠道毒性相关的败血症。其余12例患者达到循环粒细胞水平500/mm³的中位天数为29天（范围15 - 94天）。12例可评估患者中有8例在中位44天（范围12 - 116天）时血小板计数持续达到20,000/mm³或更高，4例患者在第116 - 396天死亡前未达到该水平。1例患者在第116天死于巨细胞病毒继发的间质性肺炎。8例患者在ABMT后58 - 365天（中位335天）复发，均已死亡。3例患者在ABMT后26 - 50个月存活且未复发。本研究表明，尝试移植后早期细胞毒性治疗时，植入不良是ABMT常见的并发症。该小群体患者白血病的复发率和长期存活者数量与传统治疗后的预期情况无差异。
