Bronchiolitis obliterans after bone marrow transplantation: the effect of preconditioning.
Bronchiolitis obliterans after bone marrow transplantation: the effect of preconditioning.
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骨髓移植后闭塞性细支气管炎：预处理的作用。
DOI：
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发表时间：
1993
期刊：
影响因子：
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通讯作者：
Isadore Brodsky
中科院分区：
文献类型：
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作者：
Harold L. Paz;P. Crilley;D. Topolsky;William X. Coll;Arthur Patchefsky;Isadore Brodsky
虽然接受骨髓移植（BMT）治疗恶性肿瘤和相关疾病的所有患者中有一半可以延长无病生存期，但接受同种异体移植的患者中有2-10%发生闭塞性细支气管炎（BrOb）。我们假设，全身照射（TBI）已被用于预处理可能会影响后续发展的BrOb患者接受同种异体骨髓移植。自1976年以来，我们已经治疗了104例接受异基因骨髓移植与非TBI预处理的患者。在60例存活并可评价慢性移植物抗宿主病（GVHD）的患者中，26例发展为慢性GVHD（43%）。104例患者中有4例（3.9%）通过临床和/或病理结果发展为BrOb。4例BrOb患者（100%）有慢性GVHD。这4例患者中有2例（50%）在2年结束时存活。这些数据表明，慢性GVHD是接受非TBI预处理方案的患者中BrOb的风险因素。与其他使用TBI的研究相比，该人群中BrOb的发生率相似，表明预处理方案不是BrOb发生的因素。需要进一步的研究来证实这些发现。异基因骨髓移植（BMT）彻底改变了治疗急、慢性白血病、再生障碍性贫血和罕见免疫缺陷疾病的方法。接受BMT的所有患者中有一半实现了长期无病生存，但类似数量的患者出现了严重的并发症[1]。（250字处删节）
While half of all patients receiving bone marrow transplantation (BMT) for malignancies and related diseases may achieve prolonged disease-free survival, 2-10% of patients undergoing allogeneic transplantation develop bronchiolitis obliterans (BrOb). We have hypothesized that total body irradiation (TBI) which has been used for pretreatment may influence the subsequent development of BrOb in patients undergoing allogeneic BMT. Since 1976, we have treated 104 patients undergoing allogeneic BMT with non-TBI preconditioning. Of 60 patients that survived and were evaluable for chronic graft versus host disease (GVHD) 26 developed chronic GVHD (43%). Four of 104 patients (3.9%) developed BrOb by clinical and/or pathologic findings. Four of 4 patients (100%) with BrOb had chronic GVHD. Two of these 4 patients (50%) were alive at the end of 2 years. These data demonstrate that chronic GVHD is a risk factor for BrOb in patients receiving non-TBI preconditioning regimens. The similar incidence of BrOb in this population compared to other studies using TBI suggest that the preconditioning regimen is not a factor in the development of BrOb. Further study is needed to confirm these findings. Allogeneic bone marrow transplantation (BMT) has revolutionized the therapeutic approach toward acute and chronic leukemias, aplastic anemia and rare immunodeficiency disorders. Half of all patients that undergo BMT achieve long-term disease-free survival but a similar number develop significant complications [1].(ABSTRACT TRUNCATED AT 250 WORDS)