Hägglund H, Ringdén O, Agren B, Wennberg L, Remberger M, Rundquist L, Svahn B M, Aspelin P
Department of Transplantation Surgery, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
Bone Marrow Transplant. 1998 Feb;21(4):331-5. doi: 10.1038/sj.bmt.1701116.
Thirty-eight patients (> or = 18 years) receiving marrow transplants from HLA-identical or one antigen-mismatched related donors were randomized to intraosseous (i.o.) + intravenous (i.v.) (n = 10), i.o. (n = 8) or i.v. (n = 20) infusions of bone marrow. There were no significant differences in patient characteristics. PMN/l more than 0.5 x 10(9) occurred on days 19 (median), 20 and 18.5 in the i.o. + i.v., i.o. and i.v. groups, respectively. We found a significant reduction in the number of days on total parenteral nutrition (P = 0.03) and a tendency to a reduction in the number of days on antibiotics (P = 0.06) in the i.o. compared to the i.v. group. Bacteraemia did not occur in the i.o. group, but was seen in 30% of the i.v. group (NS). The incidences of acute and chronic graft-versus-host disease, transplantation-related mortality, relapse and patient survival rates were similar in the three groups. Five patients examined with bone marrow scintigraphy showed the same distribution of granulocytes in the bone marrow directly after transplantation and 3 weeks after transplantation, whether the bone marrow was given by the i.o. or by the i.v. route. We conclude that allogeneic bone marrow transplantation can safely be performed by i.o. infusion, but haematopoietic recovery is not improved.
38例年龄≥18岁、接受来自人类白细胞抗原（HLA）配型相同或一个抗原不相合的相关供者骨髓移植的患者被随机分为骨髓腔内（i.o.）+静脉内（i.v.）输注组（n = 10）、骨髓腔内输注组（n = 8）或静脉内输注组（n = 20）。患者特征方面无显著差异。中性粒细胞/升（PMN/l）>0.5×10⁹分别在骨髓腔内+静脉内输注组第19天（中位数）、骨髓腔内输注组第20天以及静脉内输注组第18.5天出现。我们发现与静脉内输注组相比，骨髓腔内输注组患者接受全胃肠外营养的天数显著减少（P = 0.03），且使用抗生素的天数有减少趋势（P = 0.06）。骨髓腔内输注组未发生菌血症，而静脉内输注组有30%发生菌血症（无显著性差异）。三组急性和慢性移植物抗宿主病的发生率、移植相关死亡率、复发率及患者生存率相似。5例接受骨髓闪烁扫描检查的患者显示，无论骨髓是通过骨髓腔内还是静脉内途径输注，移植后即刻及移植后3周骨髓中粒细胞的分布相同。我们得出结论，同种异体骨髓移植可通过骨髓腔内输注安全进行，但造血恢复并未改善。
