Allogeneic Bone Marrow Transplantation in Juvenile Myelomonocytic Leukemia Without Total Body Irradiation
Allogeneic Bone Marrow Transplantation in Juvenile Myelomonocytic Leukemia Without Total Body Irradiation
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无全身照射的幼年型粒单核细胞白血病同种异体骨髓移植
DOI：
10.1097/00043426-200403000-00012
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
M. Phillips
中科院分区：
文献类型：
--
作者：
D. Baker;C. Cole;J. Price;M. Phillips
本文报告了未加全身照射（TBI）预处理的异基因骨髓移植（BMT）治疗儿童青少年粒单核细胞白血病（JMML）的疗效。连续8例JMML（n = 6）或单体7（n = 2）患者在中位年龄20个月时接受BMT。供体来源包括完全匹配的相关（n = 3）、不匹配的相关（n = 2）或完全匹配的无关（n = 3）。预处理方案包括白消安、环磷酰胺和依托泊苷（VP 16）（1例患者用美法仑替代VP 16）。该系列中的第一名患者接受了TBI。移植物抗宿主病的预防是环孢菌素和甲氨蝶呤和体内T细胞耗竭（Campath 1 g）不匹配和无关移植。分别有7例和2例患者在骨髓移植前接受了化疗和脾切除术。在BMT后中位随访48个月时，5名患者仍处于缓解状态。5年总生存率为63%。所有死亡均发生在BMT时患有难治性疾病的患者中。无TBI的同种异体骨髓移植似乎是治疗JMML的有效方法，并避免了学龄前儿童TBI的一些潜在晚期后遗症。
Allogeneic bone marrow transplantation (BMT) without a total body irradiation (TBI) conditioning regimen was investigated in children with juvenile myelomonocytic leukemia (JMML). Eight consecutive patients with JMML (n = 6) or monosomy 7 (n = 2) underwent BMT at a median age of 20 months. Donor source included fully matched related (n = 3), mismatched related (n = 2), or fully matched unrelated (n = 3). The conditioning regimen included busulfan, cyclophosphamide, and etoposide (VP16) (melphalan was substituted for VP16 in one patient). The first patient in the series underwent TBI. Graft-versus-host disease prophylaxis was with cyclosporin and methotrexate and in vivo T-cell depletion (Campath 1 g) for mismatched and unrelated transplants. Seven and two patients, respectively, received chemotherapy and splenectomy before BMT. At a median follow-up of 48 months after BMT, five patients remained in remission. The overall survival rate was 63% at 5 years. All deaths occurred in patients with refractory disease at the time of BMT. Allogeneic BMT without TBI appears to be effective therapy for JMML and avoids some of the potential late sequelae of TBI in preschool children.
影响因子：
20.3
作者：
P. Emanuel;Lana J. Bates;R. Castleberry;R. Gualtieri;K. Zuckerman
通讯作者：
P. Emanuel;Lana J. Bates;R. Castleberry;R. Gualtieri;K. Zuckerman
同种异体骨髓移植治疗幼年型慢性粒细胞白血病儿童。
影响因子：
20.3
作者：
Sanders,JE;Buckner,CD;Thomas,ED;Fleischer,R;Sullivan,KM;Appelbaum,FA;Storb,R
通讯作者：
Storb,R
脾切除术对慢性粒细胞白血病同种异体骨髓移植后晚期感染、移植物抗宿主病、复发和生存的长期影响的回顾性分析。
影响因子：
20.3
作者：
Kalhs,P;Schwarzinger,I;Anderson,G;Mori,M;Clift,RA;Storb,R;Buckner,CD;Appelbaum,FR;Hansen,JA;Sullivan,KM
通讯作者：
Sullivan,KM