Takemoto Y, Kanamaru A
Department of Internal Medicine, Hyogo College of Medicine.
Rinsho Ketsueki. 1993 Mar;34(3):289-93.
Each nineteen patients with severe aplastic anemia (SAA) and myelodysplastic syndrome (MDS) have been treated by allogeneic bone marrow transplantation (BMT) at Hyogo College of Medicine between 1980 and 1991. Rejection was one of the major problems for SAA patients. Conditioning regimen including irradiation reduced the rejection rate, but secondary cancers may develop as the dose of irradiation increased. It is practically important to determine the indication of BMT for MDS-refractory anemia (RA). We considered the indication of BMT for those who have abnormal karyotypes and/or life threatening complications. Five out of nine patients with MDS-RA are surviving after BMT. Four out of ten cases with MDS RAEB-T and overt leukemia are alive. BMT should be recommended for patients with MDS who satisfy the above conditions, if suitable donors are available. However, it remains to be determined whether the patients with RAEB or MDS overt leukemia should be treated with chemotherapy prior to the preconditioning for BMT.
1980年至1991年间，兵库医科大学对19例严重再生障碍性贫血（SAA）和骨髓增生异常综合征（MDS）患者进行了异基因骨髓移植（BMT）治疗。排斥反应是SAA患者的主要问题之一。包括放疗在内的预处理方案降低了排斥率，但随着放疗剂量的增加，可能会发生继发性癌症。确定MDS难治性贫血（RA）患者的BMT适应症在实际应用中很重要。我们认为，对于那些有核型异常和/或危及生命并发症的患者，可考虑进行BMT。9例MDS-RA患者中有5例在BMT后存活。10例MDS RAEB-T和明显白血病患者中有4例存活。如果有合适的供体，对于符合上述条件的MDS患者，应推荐进行BMT。然而，RAEB或MDS明显白血病患者在进行BMT预处理之前是否应先接受化疗，仍有待确定。
