Thuret I, Michel G, Carla H, Chambost H, Blaise D, Demeocq F, Maraninchi D
Unit of Paediatric Haematology, Children Hospital, La Timone, Marseille, France.
Bone Marrow Transplant. 1995 Mar;15(3):337-41.
We evaluated the long-term side-effects of allogeneic BMT performed early in the course of childhood acute leukaemia (first complete remission and interval between diagnosis and BMT not exceeding 6 months). Thirteen patients fulfilled these criteria. Conditioning regimens included TBI in eight cases. Evaluation of growth and pubertal development, ophthalmological examination, assessment of thyroid, cardiac and pulmonary functions were performed. Neuropsychological evaluation included IQ score, memory tests and cranial MRI. Median follow-up after BMT was 5 years (range 2-10 years). Growth was normal in seven patients. Six patients experienced a decrease in SD score for height (range -0.1 to -1.9). Four children were evaluable for puberty: pubertal development was normal in three children and delayed in one case. Thyroid and left ventricular function were normal in all cases. Three patients had mild abnormalities of pulmonary function. In two patients cataracts were noted 7 and 10 years after fTBI. Mean full-scale IQ score was 102. Memory tests, performed in 12 cases, were in the normal range for 11 patients. In our study, frequency and severity of long-term side-effects following BMT for leukemia appeared lower than usually reported. A possible explanation is that children were transplanted very early in the course of their disease with neither cranial irradiation nor long exposure to chemotherapy prior to transplant.
我们评估了在儿童急性白血病病程早期（首次完全缓解且诊断与异基因骨髓移植之间的间隔不超过6个月）进行异基因骨髓移植的长期副作用。13名患者符合这些标准。预处理方案包括8例采用全身照射。进行了生长和青春期发育评估、眼科检查、甲状腺、心脏和肺功能评估。神经心理学评估包括智商得分、记忆测试和头颅磁共振成像。骨髓移植后的中位随访时间为5年（范围2 - 10年）。7名患者生长正常。6名患者身高标准差得分下降（范围 -0.1至 -1.9）。4名儿童可进行青春期评估：3名儿童青春期发育正常，1例延迟。所有病例的甲状腺和左心室功能均正常。3名患者有轻度肺功能异常。2名患者在分次全身照射后7年和10年出现白内障。平均全量表智商得分为102。12例进行的记忆测试中，11名患者在正常范围内。在我们的研究中，白血病骨髓移植后长期副作用的频率和严重程度似乎低于通常报道的情况。一种可能的解释是，儿童在疾病病程早期就接受了移植，移植前既未进行头颅照射也未长期接触化疗。
