De Witte T
Department of Haematology, University Hospital St. Radboud, Nijmegen, The Netherlands.
Pathol Biol (Paris). 1997 Oct;45(8):643-9.
Allogeneic bone marrow transplantation is the only currently available curative treatment for myelodysplastic syndromes (MDSs) but can be used only in the minority of patients (10%) who are younger than 55 years or so and for whom an HLA-identical donor is available. Each year in Europe, about 100 patients with MDSs receive an autologous bone marrow transplant. This procedure is usually indicated as first-line treatment, except in patients without excess of blasts or complex cytogenetic abnormalities. In forms with excess of blasts, chemotherapy prior to bone marrow transplantation deserves discussion. Autologous bone marrow transplants or the more recent technique involving transplantation of autologous peripheral stem cells can be considered in patients who have achieved a complete remission under aggressive chemotherapy. This method has been followed by higher recurrence rates in patients with MDSs than in those with de novo acute myeloblastic leukemia, and randomized studies are under way to compare it with aggressive maintenance chemotherapy.
异基因骨髓移植是目前唯一可用于治疗骨髓增生异常综合征（MDS）的根治性疗法，但仅适用于少数年龄在55岁左右及以下且有 HLA 匹配供体的患者（10%）。在欧洲，每年约有100例MDS患者接受自体骨髓移植。此程序通常作为一线治疗，除非患者不存在原始细胞过多或复杂的细胞遗传学异常情况。在原始细胞过多的类型中，骨髓移植前的化疗值得探讨。对于在强化化疗后实现完全缓解的患者，可考虑进行自体骨髓移植或采用涉及自体外周干细胞移植的更新技术。与初发急性髓细胞白血病患者相比，MDS患者采用这种方法后的复发率更高，目前正在进行随机研究以将其与强化维持化疗进行比较。
