Tabbara I A
George Washington University, School of Medicine, Bone Marrow Transplant Program, Washington, DC 20037, USA.
Anticancer Res. 1996 Mar-Apr;16(2):1019-26.
Allogeneic bone marrow transplantation (BMT) following high-dose marrow-ablative chemoradiotherapy, has been established as the treatment of choice for various hematologic, neoplastic, and congenital disorders. This procedure is performed to restore lymphohematopoiesis in patients with bone marrow failure states, to replace a diseased marrow by a healthy donor marrow, and as "rescue" to reconstitute lymphohematopoiesis following marrow-ablative chemoradiotherapy to eradicate a malignancy. Only 30 percent of patients requiring marrow transplantation have an HLA-compatible sibling and very few patients have an identical twin donor (syngeneic graft). Over the past few years, marrows from unrelated HLA-compatible donors have been used with increasing frequency and promising outcome in certain hematologic malignancies. Infectious complications, graft-versus-host disease, veno-occlusive disease of the liver, leukemic relapse, and graft failure, remain major obstacles adversely affecting the outcome of patients undergoing allogeneic BMT. Despite these complications, allogeneic BMT remains a highly successful therapeutic procedure associated with a 20% to 90% long-term disease-free survival in a variety of patients.
大剂量骨髓清除性放化疗后的异基因骨髓移植（BMT）已被确立为各种血液系统疾病、肿瘤性疾病和先天性疾病的首选治疗方法。进行该手术的目的是恢复骨髓衰竭患者的淋巴细胞生成，用健康供体骨髓替代患病骨髓，并作为“挽救措施”在骨髓清除性放化疗后重建淋巴细胞生成以根除恶性肿瘤。仅30%需要骨髓移植的患者有人类白细胞抗原（HLA）匹配的同胞，很少有患者有同卵双胞胎供体（同基因移植）。在过去几年中，来自HLA匹配的无关供体的骨髓在某些血液系统恶性肿瘤中的使用频率越来越高，且结果令人鼓舞。感染性并发症、移植物抗宿主病、肝静脉闭塞性疾病、白血病复发和移植物失败，仍然是对接受异基因BMT患者的预后产生不利影响的主要障碍。尽管有这些并发症，异基因BMT仍然是一种非常成功的治疗方法，在各种患者中与20%至90%的长期无病生存率相关。
