Gunsilius E, Petzer A, Gastl G
Abteilung für Hämatologie und Onkologie, Universitätsklinik für Innere Medizin, Innsbruck.
Acta Med Austriaca. 1997;24(3):102-7.
Transplant studies in a variety of malignant diseases suggest that dose intensification with peripheral stem cell support can be safely applied to a wide range of patients. The clinical results are comparable to that after autologous bone marrow transplantation by achieving long lasting remissions, even in advanced disease. Clinical studies evaluating this therapeutic modality in leukemias, Hodgkin's-and non-Hodgkin's lymphoma, myeloma, and in chemotherapy-sensitive solid tumors are in progress. The clinical results compared to conventional chemotherapy are summarized in Table 1. Several approaches are targeted at improved elimination of malignant cells: 1) incorporation of new drugs into preparative conditioning regimens, 2) tandem or multiple cycles of high-dose chemotherapy followed by stem cell rescue, 3) post-transplant immunomodulation aimed at inducing an antitumor effect, and 4) purging techniques to eliminate contaminating tumor cells from the transplant. Improvements in stem cell technology and supportive care will decrease the mortality of the procedure and leed to a substancial cost reduction.
针对多种恶性疾病的移植研究表明，在外周血干细胞支持下进行剂量强化可安全应用于广泛的患者群体。临床结果与自体骨髓移植相当，即使在晚期疾病中也能实现长期缓解。目前正在进行评估这种治疗方式在白血病、霍奇金淋巴瘤和非霍奇金淋巴瘤、骨髓瘤以及化疗敏感实体瘤中的临床研究。与传统化疗相比的临床结果总结于表1。有几种方法旨在更好地清除恶性细胞：1）将新药纳入预处理方案；2）串联或多个周期的大剂量化疗后进行干细胞救援；3）移植后免疫调节以诱导抗肿瘤作用；4）清除技术以从移植中消除污染的肿瘤细胞。干细胞技术和支持性护理的改进将降低该手术的死亡率并大幅降低成本。
