Treatment of chronic granulocytic leukemia by chemotherapy, total body irradiation and allogeneic bone marrow transplantation.
Treatment of chronic granulocytic leukemia by chemotherapy, total body irradiation and allogeneic bone marrow transplantation.
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通过化疗、全身照射和同种异体骨髓移植治疗慢性粒细胞白血病。
作者：
K. Doney;Buckner Cd;G. Sale;R. Ramberg;C. Boyd;Thomas Ed
14例慢性粒细胞白血病患者接受了人类白细胞抗原相合同胞的骨髓移植。10名患者在移植前处于急变期，3名患者处于疾病的加速期，1名患者是化疗后的再生障碍性贫血。移植前所有患者均接受化疗，包括环磷酰胺加1000rad全身照射。10名患者成功植入，4名患者在没有功能移植物的情况下在骨髓输注后1-26天死亡。由于植入延迟，两名患者接受了第二次供体骨髓输注。骨髓细胞剂量和骨髓纤维化的存在与成功植入无关。十分之三的移植患者患上移植物抗宿主病。7例发生间质性肺炎。直接死因是6名患者的细菌败血症。在十分之九的可评估患者中，白血病的所有证据都消失了。中位生存期为43天。1例完全缓解，持续16个月。
Fourteen patients with chronic granulocytic leukemia received bone marrow grafts from HLA identical siblings. Ten patients were in blast crisis prior to grafting, three were in an accelerated phase of their disease, and one was aplastic secondary to chemotherapy. Prior to transplant all patients were conditioned with chemotherapy including cyclophosphamide plus 1,000 rad of total body irradiation. Ten patients achieved engraftment while four died 1 to 26 days after marrow infusion without functioning grafts. Two patients received a second infusion of donor marrow because of delayed engraftment. Neither marrow cell dose nor presence of myelofibrosis correlated with successful engraftment. Three out of ten engrafted patients developed graft-versus-host disease. Interstitial pneumonia occurred in seven patients. The immediate cause of death was bacterial septicemia in six patients. All evidence of leukemia disappeared in nine out of ten evaluable patients. The median survival was 43 days. One patient had a complete remission of 16 months duration.