BONE-MARROW TRANSPLANTATION FOR ACUTE LEUKAEMIA IN FIRST REMISSION
BONE-MARROW TRANSPLANTATION FOR ACUTE LEUKAEMIA IN FIRST REMISSION
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急性白血病首次缓解期的骨髓移植
DOI：
10.1016/s0140-6736(82)90048-4
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
M. Bortin
中科院分区：
文献类型：
--
作者：
R. Gale;H. Kay;A. Rimm;M. Bortin
在1978年至1980年期间，133名急性髓性白血病患者接受了来自HLA相同同胞的异基因骨髓移植，并随访至少一年。移植前准备包括高剂量化疗和/或放疗，移植后免疫抑制包括甲氨蝶呤或环孢素A。第一次完全缓解时移植的76例患者的数据与第二次至第四次缓解、部分缓解或复发时移植的57例患者的结果进行了比较。首次缓解时移植的患者2年生存率为48%（95%CI，36-60%），晚期患者为30%（95%CI，17-43%）（p = 0.037）。移植时的疾病状态与存活率相关（p<0.02）。首次缓解时移植的患者的2年精确白血病复发率为32%，晚期患者为50%（p = 0.0017）。维持缓解的可能性也与移植时的疾病状态相关（p<0.01）。移植物抗宿主病和间质性肺炎的发生率在首次缓解和以后移植的患者中相似，甲氨蝶呤和环孢素A在修饰急性GVHD方面同样有效。这些数据表明，大约一半的急性髓性白血病患者在首次完全缓解期间接受HLA相同同胞骨髓移植，可以延长生存期。
Between 1978 and 1980 133 patients with acute myelogenous leukaemia were given allogeneic bone-marrow transplants from an HLA-identical sibling and were followed up for at least a year. Pre-transplant preparation consisted of high-dose chemotherapy and/or radiation and post-transplant immune suppression consisted of methotrexate or cyclosporin-A. Data for 76 patients transplanted in first complete remission were compared with results in 57 patients transplanted in either second to fourth remission, partial remission, or relapse. The 2-year actuarial survival-rate was 48% (95% CI, 36-60%) for patients transplanted in first remission and 30% (95% CI, 17-43%) for patients with more advanced disease (p = 0·037). Disease status at the time of transplantation was related to the probability of survival (p<0·02). The 2-year actuarial leukaemia recurrence-rate was 32% for patients transplanted in first remission and 50% for patients with more advanced disease (p = 0·0017). The probability of remaining in remission also was associated with disease status at time of transplantation (p<0·01). The incidence of graft-vs-host disease and interstitial pneumonitis was similar for patients transplanted in first remission and those transplanted later, and methotrexate and cyclosporin A were equally effective in modifying acute GVHD. These data indicate that prolonged survival can be achieved in approximately one-half of patients with acute myelogenous leukaemia given transplants of bone marrow from an HLA-identical sibling during their first complete remission.
影响因子：
158.5
作者：
RAMSAY, NKC;KERSEY, JH;NESBIT, ME
通讯作者：
NESBIT, ME