Allogeneic or autologous bone marrow transplantation for acute lymphoblastic leukemia in first complete remission.
Allogeneic or autologous bone marrow transplantation for acute lymphoblastic leukemia in first complete remission.
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发表时间：
1990
影响因子：
4.8
通讯作者：
D. Blaise;Gaspard Mh;Stoppa Am;G. Michel;Gastaut Ja;G. Lepeu;N. Tubiana;Blanc Ap;J. Rossi;G. Novakovitch
中科院分区：
文献类型：
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作者：
D. Blaise;Gaspard Mh;Stoppa Am;G. Michel;Gastaut Ja;G. Lepeu;N. Tubiana;Blanc Ap;J. Rossi;G. Novakovitch
47例高危急性淋巴细胞白血病(ALL)患者接受了异基因(异体)或自体(BMT)骨髓移植。两组患者在年龄、初发急性淋巴细胞白血病和诱导化疗方面具有可比性。ALLO患者移植时间(CR后中位数3个月)早于All患者(CR后中位数6.5个月)。AUTO患者在BMT前接受了更多的巩固化疗。所有患者在环磷酰胺60 mg/kg x2(异体18例，自体5例)或马法兰140 mg/m2(异体7例，自体17例)后接受全身照射2.2Gyd×5d。移植物抗宿主病(GVHD)的预防是通过常规免疫抑制，17名患者和8名T细胞耗尽。7名患者(28%)发展为中到重度急性移植物抗宿主病。每例患者的自体骨髓均进行体外处理。7例CR患者死于骨髓移植并发症(5例为异基因移植，2例为自体移植)。接受allo BMT的患者的复发概率为9%，接受Auto BMT的患者的复发概率为52%(p<0.01)。无瘤存活率：allo BMT为71%，Auto BMT为40%(p=NS)。对于首次完全缓解的高危急性淋巴细胞白血病患者，早期骨髓移植是一种有效的巩固方式。本研究证实了同种异体抗白血病作用。
Forty-seven patients with high risk acute lymphoblastic leukemia (ALL) received an allogeneic (allo) or autologous (auto) bone marrow transplant (BMT). Patients in both groups were comparable in terms of age, initial presentation of ALL and induction chemotherapy. Allo patients were transplanted earlier (median 3 months after CR) than auto patients (median 6.5 months after CR). Auto patients received more consolidation chemotherapy before BMT. All patients received total body irradiation 2.2 Gy/day x 5 days after cyclophosphamide 60 mg/kg x 2 (18 allo and five auto) or melphalan 140 mg/m2 (seven allo and 17 auto). Prevention of graft-versus-host disease (GVHD) was by conventional immunosuppression in 17 patients and T cell depletion in eight. Seven patients (28%) developed moderate to severe acute GVHD. Auto marrow was treated in vitro in each case. Seven patients died in CR from BMT complications (five allo and two auto). The probability of relapse was 9% for patients receiving allo BMT and 52% for patients receiving auto BMT (p less than 0.01). The disease-free survival was 71% for allo BMT and 40% for auto BMT (p = NS). Early BMT is an effective form of consolidation for high risk patients with ALL in first CR. An allogeneic anti-leukemia effect was demonstrated in this study.