Uckun F M, Myers D E
Department of Therapeutic Radiology-Radiation Oncology, Pharmacology and Pediatrics, University of Minnesota Health Sciences Center, Minneapolis 55455.
J Hematother. 1993 Summer;2(2):155-63. doi: 10.1089/scd.1.1993.2.155.
Bone marrow manipulation is an essential procedure when bone marrow transplantation (BMT) is used to improve the chances of survival among high risk patients with hematologic malignancies. Ex vivo purging of donor T cells effectively prevents a fatal reaction known as graft-versus-host disease in allogeneic BMT. Ex vivo purging of residual leukemia cells from autologous marrow can virtually eliminate the risk of autograft contamination. Immunotoxins are powerful and selective reagents for these tasks. However, ex vivo purging may be insufficient by itself to overcome the high risk of relapse that confronts many patients undergoing autologous BMT. Bone marrow manipulation may even present problems of its own, such as loss of the graft-versus-leukemia effect when allogeneic marrow is T cell depleted. We are currently evaluating immunotoxins containing pokeweed antiviral protein in clinical trials as in vivo purging reagents that may reduce the risk of relapse for BMT patients.
当采用骨髓移植（BMT）来提高血液系统恶性肿瘤高危患者的生存几率时，骨髓处理是一项必不可少的程序。在异基因BMT中，体外清除供体T细胞可有效预防一种名为移植物抗宿主病的致命反应。从自体骨髓中体外清除残留白血病细胞实际上可以消除自体移植污染的风险。免疫毒素是用于这些任务的强大且具有选择性的试剂。然而，仅靠体外清除本身可能不足以克服许多接受自体BMT的患者所面临的高复发风险。骨髓处理甚至可能自身带来问题，比如当异基因骨髓的T细胞被清除时，会丧失移植物抗白血病效应。我们目前正在临床试验中评估含有商陆抗病毒蛋白的免疫毒素，将其作为体内清除试剂，这可能会降低BMT患者的复发风险。
