McCann S R, Lawler M, Bacigalupo A
Department of Hematology, St. James Hospital, Dublin, Ireland.
Leuk Lymphoma. 1993 Aug;10(6):419-25. doi: 10.3109/10428199309148198.
Allogeneic bone marrow transplantation has been shown to be a very effective therapy for Chronic Granulocytic Leukemia with long term disease free survivals in excess of 60%. Relapse rates remain low at 15% following histocompatible sibling transplants and lower rates following matched unrelated donor grafts. Relapse rates however, are higher if BMT is carried out in transformation or blast crisis. Leukemic relapse in donor cells following transplantation for CGL is a rare event. The occurrence of donor leukemia however, may be under reported as accurate and sensitive investigation of the origin of relapsed leukemia following BMT requires DNA based technologies. A possible mechanism of donor leukemia in CGL is transfection of donor cells with the chimeric gene which is unique to this disease. It is possible that the malignant cells found in transformed or blast crisis of CGL may have a greater potential to transfect donor haematopoietic material. Careful evaluation of the incidence of donor leukemia using molecular biology methods may elucidate the frequency of this event following BMT for CGL.
异体骨髓移植已被证明是治疗慢性粒细胞白血病的一种非常有效的疗法，长期无病生存率超过60%。在进行组织相容性同胞移植后，复发率仍较低，为15%，而在匹配的无关供体移植后复发率更低。然而，如果在疾病转化期或急变期进行骨髓移植，复发率会更高。慢性粒细胞白血病移植后供体细胞发生白血病复发是罕见事件。然而，供体白血病的发生可能报告不足，因为对骨髓移植后复发白血病的起源进行准确而敏感的调查需要基于DNA的技术。慢性粒细胞白血病中供体白血病的一种可能机制是供体细胞被该疾病特有的嵌合基因转染。有可能在慢性粒细胞白血病转化期或急变期发现的恶性细胞转染供体造血物质的潜力更大。使用分子生物学方法仔细评估供体白血病的发生率可能会阐明慢性粒细胞白血病骨髓移植后这一事件的发生频率。
