Porter D L, Antin J H
Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Leuk Lymphoma. 1995 Apr;17(3-4):191-7. doi: 10.3109/10428199509056823.
Donor mononuclear cell (MNC) infusions provide a very potent and effective anti-leukemic therapy. For patient's with CML who relapse after allogeneic BMT, the administration of donor MNC can result in a direct GVL effect and re-establish sustained remissions, even when assessed by very sensitive PCR-based techniques. The GVL reaction appears to be most prominent in patients with chronic phase CML. It is less apparent for patients with more advanced stages of CML or for patients with relapsed acute leukemia and myelodysplasia, although only small numbers of these patients have been treated. While the majority of patients tolerate this therapy very well, treatment related morbidity and mortality is still quite significant, and efforts to limit the severity of GVHD, and to recognize and treat marrow aplasia early may be useful. Longer follow-up of patients who have achieved complete remission will be required to determine if this therapy will have an impact on long term disease free survival, but at the current time, it would seem to be a very acceptable alternative to a second BMT.
供体单个核细胞（MNC）输注提供了一种非常有效且高效的抗白血病疗法。对于异基因骨髓移植（BMT）后复发的慢性粒细胞白血病（CML）患者，即使通过非常灵敏的基于聚合酶链反应（PCR）的技术评估，给予供体MNC也可产生直接的移植物抗白血病（GVL）效应并重建持续缓解状态。GVL反应在慢性期CML患者中似乎最为显著。对于CML更晚期患者或复发的急性白血病和骨髓增生异常综合征患者，GVL反应不太明显，尽管接受治疗的此类患者数量较少。虽然大多数患者对这种疗法耐受性良好，但治疗相关的发病率和死亡率仍然相当高，限制移植物抗宿主病（GVHD）的严重程度以及早期识别和治疗骨髓再生障碍的努力可能会有所帮助。需要对已实现完全缓解的患者进行更长时间的随访，以确定这种疗法是否会对长期无病生存产生影响，但目前看来，它似乎是第二次BMT的一个非常可接受的替代方案。
