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[异基因骨髓移植治疗恶性血液病]

[Allogenic bone marrow transplantation in the treatment of malignant hematologic disease].

作者信息

Barriga F, Bertín P, Baeza R, Pereira J, Schwartzmann L, Oliva J, Ocqueteau M, Sapunar F, Duhalde M, Lira P

机构信息

Departamento de Pediatría, Universidad Católica de Chile, Santiago de Chile.

出版信息

Rev Med Chil. 1995 May;123(5):605-11.

PMID:8525207
Abstract

We have treated 28 patients (pts) with malignant hematological diseases with allogeneic bone marrow transplantation (BMT). 18 pts had acute lymphoblastic (ALL) and non lymphoblastic leukemia (ANLL), 5 chronic myeloid leukemia (CML), 2 severe aplastic anemia (SAA), 1 myelodisplasia, 1 Fanconi's anemia and 1 advanced Non Hodgkin's lymphoma. All but three received the graft from HLA identical sibling donors. We used conditioning with total body irradiation and chemotherapy (cyclophosphamide, cytarabine and etoposide) in 17 pts and chemotherapy alone in 11. 24 pts had full hematological recovery 18 to 25 days post BMT. 15 pts died after BMT as a consequence of toxicity or early infection (4), graft failure (2), graft versus host disease (4) or relapse (5). Actuarial event free survival for the group with favorable prognosis (SAA, ALL and ANLL in first or second remission and CML in chronic phase) is 57% at 36 months. Allogeneic BMT is an effective and feasible therapeutic procedure for selected patients with hematological malignancies.

摘要

我们采用异基因骨髓移植(BMT)治疗了28例恶性血液病患者。18例为急性淋巴细胞白血病(ALL)和非淋巴细胞白血病(ANLL),5例为慢性粒细胞白血病(CML),2例为重型再生障碍性贫血(SAA),1例为骨髓发育异常,1例为范可尼贫血,1例为晚期非霍奇金淋巴瘤。除3例外,所有患者均接受了来自HLA配型相合的同胞供者的移植物。17例患者采用全身照射和化疗(环磷酰胺、阿糖胞苷和依托泊苷)进行预处理,11例仅采用化疗。24例患者在BMT后18至25天实现了完全血液学缓解。15例患者在BMT后因毒性反应或早期感染(4例)、移植物失败(2例)、移植物抗宿主病(4例)或复发(5例)而死亡。预后良好组(SAA、处于首次或第二次缓解期的ALL和ANLL以及慢性期的CML)的无事件生存率在36个月时为57%。异基因BMT对于部分血液系统恶性肿瘤患者是一种有效且可行的治疗方法。

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