Nemet D, Labar B, Bogdanic V, Skodlar J, Petrovecki M, Mrsic M, Maravic N, Sneller V, Radman I, Kovacevic-Metelko J
Department of Medicine, University Hospital Rebro, Croatia.
Wien Med Wochenschr. 1995;145(2-3):61-4.
From April 1988 to May 1993, 71 patients (32 acute myelogenous leukaemia [AML], 24 acute lymphoblastic leukaemia [ALL], 7 Hodgkin's disease [HD], 5 non-Hodgkin lymphoma [NHL], 2 neuroblastoma, 1 chronic myelogenous leukaemia [CML]) were treated with myeloablative therapy followed by reinfusion of cryopreserved autologous bone marrow (ABMT). The majority of patients with acute leukaemia were in first complete remission (CR), while 11 AML patients and 9 ALL patients were in advanced stage of the disease (> I CR or relapse). The BM was reinfused without purging. The conditioning regimen for all ALL and proportion of AML patients consisted of cyclophosphamide (CY) 120 mg/kg and fractionated total body irradiation (TB) in a total dose of 12 Gy. 18 AML patients received busulfan 16 mg/kg instead of TBI. Leukaemia-free survival (LFS) for first CR AML patients was 48% at 43 months with the median follow-up of 17 months. Probability of relapse was 44%. LFS for advanced AML was only 9% and the probability of relapse 89%. LFS for first CR ALL patients was 72% at 53 months with the median follow-up of 15 months, while probability of relapse was only 23%. For advanced ALL, LFS was 32% at 33 months and probability of relapse 64%. Probability of toxic death for first CR patients was 11%. We found a predictive value of viability testing and in vitro CFU-GM assay for haematologic recovery after ABMT. We conclude that ABMT with cryopreserved BM is a relatively safe method for consolidation therapy of AL. The results of treatment are encouraging.(ABSTRACT TRUNCATED AT 250 WORDS)
1988年4月至1993年5月，71例患者（32例急性髓细胞白血病[AML]、24例急性淋巴细胞白血病[ALL]、7例霍奇金病[HD]、5例非霍奇金淋巴瘤[NHL]、2例神经母细胞瘤、1例慢性髓细胞白血病[CML]）接受了清髓性治疗，随后回输冷冻保存的自体骨髓（ABMT）。大多数急性白血病患者处于首次完全缓解（CR）期，而11例AML患者和9例ALL患者处于疾病晚期（> I CR或复发）。骨髓回输时未进行净化处理。所有ALL患者及部分AML患者的预处理方案包括环磷酰胺（CY）120 mg/kg和分次全身照射（TB），总剂量为12 Gy。18例AML患者接受了16 mg/kg白消安而非TBI。首次CR的AML患者在43个月时无白血病生存率（LFS）为48%，中位随访时间为17个月。复发概率为44%。晚期AML患者的LFS仅为9%，复发概率为89%。首次CR的ALL患者在53个月时LFS为72%，中位随访时间为15个月，而复发概率仅为23%。对于晚期ALL患者，33个月时LFS为32%，复发概率为64%。首次CR患者的毒性死亡概率为11%。我们发现活力检测和体外CFU - GM测定对ABMT后血液学恢复具有预测价值。我们得出结论，冷冻保存骨髓的ABMT是AL巩固治疗的一种相对安全的方法。治疗结果令人鼓舞。（摘要截短至250字）
