Dini G, Cornish J M, Gadner H, Souillet G, Vossen J M, Paolucci P, Manfredini L, Miano M, Niethammer D
G.Gaslini Institute, Genova, Italy.
Bone Marrow Transplant. 1996 Nov;18 Suppl 2:4-7.
During the "2nd International Course on Bone Marrow Transplantation in Children" a multiple choice questionnaire on bone marrow transplant indications for children with acute leukemias was distributed with the aim of achieving a consensus. The answers obtained from the twenty representatives of fourteen European countries during the meeting were analyzed and assigned to one of the following groups: I. definitive indication: when more than 75% participants were in favour; II. acceptable indication: when 50% to 74% participants were in favour; III. requires further investigation: when 25% to 49% participants were in favour; IV. no indication: when less than 24% participants were in favour. In acute lymphoblastic leukemia the following circumstances were considered a definitive indication for allogeneic bone marrow transplant (BMT) from a matched sibling donor (MSD): infancy, "high risk" (HR) patients in 1st complete remission (CR1); CR2 patients after an early bone marrow relapse (defined as a relapse occurring up to six months after stopping therapy). Patients experiencing an early meningeal relapse and CR2 patients after a late relapse (defined as a relapse occurring later than six months after stopping therapy) were considered an acceptable indication. Further investigation was required in order to better define the role of BMT for patients experiencing an early isolated testicular relapse. If a MSD is not available, HR patients in CR1 and CR2 patients, after an early bone marrow relapse, were considered a definite indication for a matched unrelated donor (MUD). This latter group was considered an acceptable indication for a haploidentical BMT if a MUD was not available. Further investigation was required to better define the role of autologous bone marrow transplant (ABMT) for patients experiencing an early extramedullary relapse and for HR patients in CR1 all of whom lacked MSD's. In acute myeloblastic leukemia (AML), CR2 patients were considered a definitive indication and CR1 patients were considered an acceptable indication for BMT from a MSD. CR2 patients were considered a definitive indication for ABMT and CR1 patients an acceptable indication in cases lacking a MSD. AML was not considered an indication for MUD BMT.
在“第二届儿童骨髓移植国际课程”期间，发放了一份关于急性白血病患儿骨髓移植适应症的多项选择题问卷，目的是达成共识。对会议期间来自14个欧洲国家的20名代表给出的答案进行了分析，并归入以下组别之一：I. 明确适应症：超过75%的参与者赞成；II. 可接受适应症：50%至74%的参与者赞成；III. 需要进一步研究：25%至49%的参与者赞成；IV. 无适应症：少于24%的参与者赞成。在急性淋巴细胞白血病中，以下情况被视为来自匹配同胞供者（MSD）的异基因骨髓移植（BMT）的明确适应症：婴儿期、首次完全缓解（CR1）的“高危”（HR）患者；早期骨髓复发（定义为停止治疗后6个月内发生的复发）后的CR2患者。早期脑膜复发的患者以及晚期复发（定义为停止治疗6个月后发生的复发）后的CR2患者被视为可接受适应症。对于早期孤立性睾丸复发的患者，需要进一步研究以更好地确定BMT的作用。如果没有MSD，CR1的HR患者和早期骨髓复发后的CR2患者被视为匹配无关供者（MUD）移植的明确适应症。如果没有MUD，后一组被视为单倍体相合BMT的可接受适应症。对于早期髓外复发的患者以及所有缺乏MSD的CR1的HR患者，需要进一步研究以更好地确定自体骨髓移植（ABMT）的作用。在急性髓细胞白血病（AML）中，CR2患者被视为来自MSD的BMT的明确适应症，CR1患者被视为可接受适应症。CR2患者被视为ABMT的明确适应症，在缺乏MSD的情况下，CR1患者被视为可接受适应症。AML不被视为MUD BMT的适应症。
