Kelemen E, Dénes R, Barta A, Masszi T, Reményi P, Pálóczi K, Bátai A, Torbágyo E, Sipos A, Lengyel L, Jakab K, Gyódi E, Réti M, Földi J, Páldi-Haris P, Manuel A, Fekete S, Török J, Hoffer I, Jakab J, Váradi G, Petrányi G
Országos Hematológiai és Immunológiai Intézet Budapest.
Orv Hetil. 1998 Aug 23;139(34):2003-1; discussion 2011-2.
A new, radiation-free, conditioning protocol, containing the original Hungarian mitobronitol (DBM) (DBM/ cytosine arabinoside/cyclosphosphamide) has been applied to 36 chronic myeloid leukemia (CML) patients followed by bone marrow transplantation (BMT) from HLA identical sibling donors between 1990-1997. In spite of some prognostically disadvantageous factors (half of them were above 40 years, 10 out of 36 patients were in accelerated phase, the disease history was longer than 2 years in average) the overall survival (30/36) and the leukemia free survival rate (26/36) were in accordance with the best international results. Transplantation-related toxicity was remarkably reduced in comparison to bone marrow transplantation performed by total body irradiation/cyclophosphamide (TBI/Cy) or busulphan/cyclophosphamide (Bu/Cy) conditioning protocols. Acute graft versus host disease was present in lower percentage (9/36) and the number of serious cases was only 2/36. Chronic GVH disease, generally known to be associated with antileukemic effect (GVL), occurred in 25 of cases. Early haematological relapse among the 34 patients with functioning graft occurred in 6 patients which rate is slightly higher than reported after TBI/Cy or Bu/Cy conditioning treatment. There was no relapse among patients transplanted within one year post-diagnosis and patients having CML with accelerated phase. The leukemia free post-transplant period was in association with the chronic GVH disease and full chimeric state.
一种新的、无辐射的预处理方案，包含原匈牙利产的米托布罗醇（DBM）（DBM/阿糖胞苷/环磷酰胺），于1990年至1997年间应用于36例慢性髓性白血病（CML）患者，随后接受来自 HLA 匹配同胞供者的骨髓移植（BMT）。尽管存在一些预后不利因素（其中一半患者年龄超过40岁，36例患者中有10例处于加速期，平均病程超过2年），总体生存率（30/36）和无白血病生存率（26/36）仍与国际最佳结果相符。与采用全身照射/环磷酰胺（TBI/Cy）或白消安/环磷酰胺（Bu/Cy）预处理方案进行的骨髓移植相比，移植相关毒性显著降低。急性移植物抗宿主病的发生率较低（9/36），严重病例仅2/36。慢性移植物抗宿主病通常与抗白血病效应（GVL）相关，发生在25例患者中。34例移植功能良好的患者中，有6例出现早期血液学复发，该复发率略高于TBI/Cy或Bu/Cy预处理治疗后的报道。诊断后一年内移植的患者以及处于加速期的CML患者未出现复发。移植后的无白血病期与慢性移植物抗宿主病和完全嵌合状态相关。
