MARROW TRANSPLANTATION FOR THE TREATMENT OF CHRONIC MYELOGENOUS LEUKEMIA
MARROW TRANSPLANTATION FOR THE TREATMENT OF CHRONIC MYELOGENOUS LEUKEMIA
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DOI：
10.7326/0003-4819-104-2-155
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发表时间：
1986-02-01
影响因子：
39.2
通讯作者：
WITHERSPOON, R
中科院分区：
文献类型：
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作者：
THOMAS, ED;CLIFT, RA;WITHERSPOON, R
198例慢性粒细胞白血病患者在接受强化化疗和全身照射后接受骨髓移植。多变量分析显示，移植时的疾病状态是生存率最有力的预测因素。在第一慢性期，67例患者的同种异体移植受体的长期存活率为49%，第二慢性期为58%，加速期为15%，急变期为14%。慢性期患者的主要死亡原因是间质性肺炎，急变期或加速期患者的主要死亡原因是复发。有利于生存的因素是早期移植，年龄小于30岁，没有严重的移植物抗宿主病。脾切除术或脾大小不影响生存。对于同系移植物的受体，慢性期16例患者的存活率为87%，加速期7例患者的存活率为27%，急变期8例患者的存活率为12%。在198例患者中，71例在接受移植后1至9年没有费城染色体存活。除4例长期无病生存者外，所有患者的Karnofsky评分均为80%或更高。
One hundred ninety-eight patients with chronic myelogenous leukemia received marrow transplants after intensive chemotherapy and total body irradiation. Multivariate analysis showed disease status at time of transplantation to be the most powerful predictor of survival. The probability of long-term survival for allogeneic graft recipients was 49% for 67 patients in the first chronic phase, 58% for 12 in the second chronic phase, 15% for 46 in the accelerated phase, and 14% for 42 in the blastic phase. The major cause of death was interstitial pneumonia for patients in the chronic phase, and relapse for those in the blastic or accelerated phases. Factors favoring survival were early transplantation, age less than 30 years, and absence of severe graft-versus-host disease. Splenectomy or spleen size did not influence survival. For recipients of syngeneic grafts survival probability was 87% for 16 patients in the chronic phase, 27% for 7 in the accelerated phase, and 12% for 8 in the blastic phase. Of the 198 patients, 71 are alive without Philadelphia chromosomes 1 to 9 years after receiving their graft. All but 4 long-term disease-free survivors have Karnofsky performance scores of 80% or better.