Masaoka T, Shibata H, Nakamura H, Inoue T
Tokai J Exp Clin Med. 1985 Jun;10(2-3):139-46.
One hundred and seventy three bone marrow transplantations (BMT) including 133 allogeneic, 17 syngeneic and 23 autologous BMT were recorded in Japan during the period between September, 1975 and March, 1984. The number of cases of BMT increased rapidly over the years, i.e., 16 cases in 1980, 27 in 1981, 39 in 1982 and 57 in 1983. All cases were treated in clean rooms, many of them receiving intensive gut decontamination containing vancomycin. In 110 cases with acute leukemia, the main causes of death were interstitial pneumonitis, relapse of leukemia, infection and GvHD. Favorable factors determined from 180-day survival were remission, no infection, low dose rate and fractionated total body irradiation (TBI), ABO minor mismatch and positive graft versus host reaction. Long-term survival of patients who received BMT during remission and were without infection amounted to 70% of acute lymphocytic leukemia (ALL) and 40% of acute myelogenous leukemia (AML) patients. Cyclosporin A (Cy-A) administered in 21 cases was compared with methotrexate (MTX) given in 20 cases. A statistically significant decrease of stomatitis was observed, while no difference in GvHD or survival was seen. There were seven cases giving a more than good response out of 11 cases treated with cyclosporin because methotrexate or immuran was ineffective or could not be administered due to toxicity. Such data suggest that allogeneic BMT is acceptable as a very promising form of treatment for acute leukemia in Japan.
1975年9月至1984年3月期间，日本共记录了173例骨髓移植（BMT），其中包括133例同种异体移植、17例同基因移植和23例自体移植。多年来，BMT病例数迅速增加，即1980年有16例，1981年有27例，1982年有39例，1983年有57例。所有病例均在洁净室接受治疗，其中许多人接受了含有万古霉素的强化肠道去污处理。在110例急性白血病患者中，主要死亡原因是间质性肺炎、白血病复发、感染和移植物抗宿主病（GvHD）。从180天生存率确定的有利因素包括缓解、无感染、低剂量率和分次全身照射（TBI）、ABO minor错配以及阳性移植物抗宿主反应。在缓解期接受BMT且无感染的患者中，急性淋巴细胞白血病（ALL）患者的长期生存率为70%，急性髓细胞白血病（AML）患者为40%。对21例使用环孢素A（Cy-A）的患者与20例使用甲氨蝶呤（MTX）的患者进行了比较。观察到口腔炎有统计学意义的下降，而在GvHD或生存率方面未见差异。在11例接受环孢素治疗的患者中，有7例反应良好，因为甲氨蝶呤或硫唑嘌呤无效或因毒性无法给药。这些数据表明，在日本，同种异体BMT作为急性白血病一种非常有前景的治疗形式是可以接受的。
