Jones R J
Johns Hopkins Oncology Center, Baltimore, Maryland.
Curr Opin Oncol. 1993 Mar;5(2):270-5. doi: 10.1097/00001622-199303000-00004.
Very high-dose cytotoxic therapy requiring bone marrow transplantation is the most active treatment for most hematologic malignancies and appears to be the treatment of choice for most patients with these diseases at relapse. Autologous bone marrow transplantation and allogeneic bone marrow transplantation can generally be expected to yield similar results in patients with lymphoma or acute leukemia; autologous bone marrow transplantation offers the advantage of greater availability and less toxicity but with a higher rate of tumor recurrence. Novel approaches that can increase the antitumor activity of autologous bone marrow transplantation without increasing the toxicity are being investigated. Dose intensification followed by autologous marrow rescue is also very active against responsive solid tumors, eg, breast cancer, ovarian cancer, testicular cancer, and pediatric solid tumors. However, it is difficult to demonstrate that autologous bone marrow transplantation has yet to lead to an improvement in disease-free survival for patients with solid tumors. Therefore, the exact role autologous bone marrow transplantation should play in the treatment of solid tumors remains to be established.
需要进行骨髓移植的极高剂量细胞毒性疗法是大多数血液系统恶性肿瘤最有效的治疗方法，对于大多数复发的此类疾病患者而言似乎是首选治疗方案。自体骨髓移植和异基因骨髓移植通常有望在淋巴瘤或急性白血病患者中产生相似的效果；自体骨髓移植具有可及性更高、毒性更小的优势，但肿瘤复发率更高。目前正在研究能够在不增加毒性的情况下提高自体骨髓移植抗肿瘤活性的新方法。剂量强化后进行自体骨髓挽救对反应性实体瘤，如乳腺癌、卵巢癌、睾丸癌和儿童实体瘤也非常有效。然而，很难证明自体骨髓移植能改善实体瘤患者的无病生存期。因此，自体骨髓移植在实体瘤治疗中的确切作用仍有待确定。
