Naohara T, Hashino S, Masauji N, Matsuura A, Ohizumi H, Kobayashi N, Morii K, Kiyama Y, Saitoh M, Higa T
Department of Internal Medicine, Sapporo Hokuyu Hospital, Artificial Organ & Transplantation Hospital, Japan.
Hokkaido Igaku Zasshi. 1994 Sep;69(5):1199-207.
The outcomes of 39 patients with hematological disorders who had undergone allogeneic bone marrow transplantation (BMT) from September 1986 to March 1992 were reported. The length of follow-up was six to 50 months. Twenty patients with acute leukemia, eight patients with aplastic anemia, seven patients with chronic myelogenous leukemia, two patients with non-Hodgkin's lymphoma, and two patients with myelodysplastic syndrome were included. Major complications were acute graft-versus-host disease (GVHD) (17 cases out of 36 evaluable cases; 47 percent), chronic GVHD (13/25; 52 percent), sepsis (20/41; 49 percent), interstitial pneumonitis (IP) (10/30; 33 percent), and veno-occlusive disease (VOD) of the liver (5/41; 12 percent). Acute and chronic GVHD were well managed with cyclosporin, methotrexate, and steroids. VOD of the liver seemed to be associated with the pretransplant regimen including busulfan and cyclophosphamide. The overall probability of disease free survival of 39 patients who had undergone allogeneic BMT was 0.56. This includes nine high risk cases such as HLA antigen mismatch between the donor and the recipient, and as in the second or subsequent remission or in relapsed cases. The probability of disease free survival in patients with acute leukemia, chronic myelogenous leukemia, and aplastic anemia including high risk cases was 0.55 (n = 20), 0.71 (n = 7), and 0.50 (n = 8) respectively. These results indicate that allogeneic BMT is the major therapeutic strategy for patients whose survival could not be expected by conventional chemotherapy and that drug intensification for conditioning regimen is also important.
报告了1986年9月至1992年3月期间39例接受异基因骨髓移植（BMT）的血液系统疾病患者的治疗结果。随访时间为6至50个月。其中包括20例急性白血病患者、8例再生障碍性贫血患者、7例慢性粒细胞白血病患者、2例非霍奇金淋巴瘤患者和2例骨髓增生异常综合征患者。主要并发症包括急性移植物抗宿主病（GVHD）（36例可评估病例中有17例；47%）、慢性GVHD（13/25；52%）、败血症（20/41；49%）、间质性肺炎（IP）（10/30；33%）和肝静脉闭塞病（VOD）（5/41；12%）。急性和慢性GVHD通过环孢素、甲氨蝶呤和类固醇得到了良好控制。肝VOD似乎与包括白消安和环磷酰胺在内的移植前方案有关。39例接受异基因BMT患者的无病生存率总体概率为0.56。这包括9例高危病例，如供体与受体之间HLA抗原不匹配，以及处于第二次或后续缓解期或复发病例。急性白血病、慢性粒细胞白血病和再生障碍性贫血患者（包括高危病例）的无病生存率分别为0.55（n = 20）、0.71（n = 7）和0.50（n = 8）。这些结果表明，异基因BMT是常规化疗无法预期生存的患者的主要治疗策略，并且预处理方案的药物强化也很重要。
