Speck B, Gratwohl A, Osterwalder B, Signer E, Corneo M, Nissen C, Jeannet M
Schweiz Med Wochenschr. 1983 Oct 8;113(40):1440-1.
9 patients with acute lymphoblastic leukaemia (ALL) were transplanted in first remission. There were no leukaemic relapses and 6 patients became longterm survivors. Causes of death were GvHD in 2 and interstitial pneumonia in 1. 14 patients with ALL were grafted in later stages of the disease. 10 had a leukaemic relapse. One attained longlasting remission with chemotherapy, while 9 died. One patient died of CMV infection. Cotton wool lesions and haemorrhages in the retina posed a problem in patients with previous cranial irradiation. We recommend transplantation of ALL in first remission if a syngeneic or HLA-identical sibling is available, particularly if the patient has poor risk factors for chemotherapy. Prophylactic cranial irradiation should be replaced by intrathecal methotrexate and/or cytosin arabinoside in these patients.
9例急性淋巴细胞白血病(ALL)患者在首次缓解期接受了移植。无白血病复发,6例患者成为长期存活者。死亡原因2例为移植物抗宿主病(GvHD),1例为间质性肺炎。14例ALL患者在疾病晚期接受了移植。10例出现白血病复发。1例通过化疗获得持久缓解,9例死亡。1例患者死于巨细胞病毒(CMV)感染。既往接受过颅脑照射的患者出现棉絮状病变和视网膜出血问题。我们建议,如果有同基因或HLA配型相同的同胞供者,尤其当患者化疗存在不良风险因素时,应在首次缓解期进行ALL移植。对于这些患者,预防性颅脑照射应改为鞘内注射甲氨蝶呤和/或阿糖胞苷。