Pejin D, Stefanović N, Belić A, Popović S, Spasojević J, Uzurov V, Savić I, Savić A
Klinika za hematologiju, Medicinski fakultet, Novi Sad.
Med Pregl. 1997 Nov-Dec;50(11-12):473-9.
The paper presents the possibilities of contemporary treatment of acute and chronic leukemia that have been based on new knowledge and experience we have gathered through clinical and scientific work. Contemporary treatment of leukemia is very complex and requires the application of cytostatics, biological therapy and transplantation of hematopoietic stem cells. The treatment of acute leukemia by cytostatics and induction protocols results in a rather high percentage of remissions, but unfortunately most of them cannot be preserved. Allogenic transplantation of hematopoietic stem cells from bone marrow or peripheral blood have given the best results in the treatment of acute and chronic leukemia. Anti-leukemic effect is bound to the previous chemoradiotherapy, particularly to the activity of donor's immunocompetent cells in the transplant, having an effect of a graft against leukemia. The cleansing of the autograft and isolation of stem cells together with the application of IL-2 will be a significant improvement of the efficacy of autologous transplantation in leukemia. It is realistic to expect that the treatment of malignant diseases such as leukemia will in near future, besides the already existing treatment methods, include molecular therapy at various cell levels, which will make possible a correction of the basic disorder in the process of malignant alteration of hematopoietic cells.
本文介绍了基于我们通过临床和科研工作所积累的新知识和经验,对急性和慢性白血病进行当代治疗的可能性。白血病的当代治疗非常复杂,需要应用细胞抑制剂、生物疗法以及造血干细胞移植。通过细胞抑制剂和诱导方案治疗急性白血病可取得相当高的缓解率,但不幸的是,大多数缓解无法维持。来自骨髓或外周血的造血干细胞同种异体移植在急性和慢性白血病治疗中取得了最佳效果。抗白血病作用与先前的放化疗相关,特别是与移植中供体免疫活性细胞的活性有关,具有移植物抗白血病效应。自体移植物的净化、干细胞的分离以及白细胞介素-2的应用将显著提高白血病自体移植的疗效。可以预期,在不久的将来,除了现有的治疗方法外,白血病等恶性疾病的治疗还将包括在不同细胞水平上的分子治疗,这将有可能纠正造血细胞恶性改变过程中的基本紊乱。