Cohen A, van Lint M T, Uderzo C, Rovelli A, Lavagetto A, Vitale V, Morchio A, Locasciulli A, Bacigalupo A, Romano C
University Department of Pediatrics, G. Gaslini Institute Children's Hospital, Genoa, Italy.
Bone Marrow Transplant. 1995 Mar;15(3):343-8.
The growth of 66 long-term survivors, transplanted in two centres (Genoa S. Martino and Monza) is reported. Patients were all under age 15 at the time of bone marrow transplantation (mean 9.8 +/- 3.4 years; range 1.07-15 years) with a minimum follow-up of at least 12 months. They were divided into four groups. Group 1: eight patients with severe aplastic anemia (SAA): conditioning included cyclophosphamide (CY) 200 mg/kg only. Group 2: 32 patients with acute lymphoblastic leukemia (ALL), and acute myeloid leukemia (AML): conditioning included CY 120 mg/kg and 10-12 Gy fractionated total body irradiation (fTBI). Group 3: 20 patients with ALL, who had previously received cranial irradiation; conditioning included CY 120 mg/kg and fTBI with an additional testicular irradiation (4 Gy). Group 4: six patients with chronic myeloid leukemia (CML) and AML; conditioning included CY 200 mg/kg and busulfan (BU) 16 mg/kg. Group was impaired in all four groups, including the unirradiated groups (-0.2 +/- 0.7 and -0.5 +/- 0.6 delta-SDS in groups I and 4, respectively). Growth impairment-SDS was statistically significant in the two irradiated groups (-0.7 +/- 1.0 and -0.9 +/- 1.0 delta-SDS in groups 2 and 3, respectively), more marked in patients who had had previous cranial irradiation. Chronic graft-versus-host disease and its treatment were not found to have a major effect on growth.
报告了在两个中心（热那亚圣马尔蒂诺和蒙扎）接受移植的66例长期存活者的生长情况。患者在进行骨髓移植时均未满15岁（平均9.8±3.4岁；范围1.07 - 15岁），最短随访时间至少为12个月。他们被分为四组。第1组：8例重型再生障碍性贫血（SAA）患者：预处理仅包括200mg/kg环磷酰胺（CY）。第2组：32例急性淋巴细胞白血病（ALL）和急性髓细胞白血病（AML）患者：预处理包括120mg/kg CY和10 - 12Gy分次全身照射（fTBI）。第3组：20例之前接受过颅脑照射的ALL患者；预处理包括120mg/kg CY和fTBI，并额外进行睾丸照射（4Gy）。第4组：6例慢性髓细胞白血病（CML）和AML患者；预处理包括200mg/kg CY和16mg/kg白消安（BU）。四组患者的生长均受到损害，包括未接受照射的组（第1组和第4组的生长迟缓标准差分别为 - 0.2±0.7和 - 0.5±0.6）。在两个接受照射的组中，生长损害标准差具有统计学意义（第2组和第3组分别为 - 0.7±1.0和 - 0.9±1.0），在之前接受过颅脑照射的患者中更为明显。未发现慢性移植物抗宿主病及其治疗对生长有重大影响。
