论文部分内容阅读
骨髓增生异常综合征(MDS)强烈化疗后的长期无病生存率令人失望,异基因骨髓移植(Allo-BMT)对MDS患者的治疗效果令人鼓舞,但文献中仅限于个例报告.为此,欧洲骨髓移植白血病协作组对78例MDS和继发性白血病(S-AML)异基因骨髓移植的疗效作了回顾性研究.78例患者来源于1981年至1988年欧洲21个骨髓移植中心.男性43例,女性35例,平均年龄35岁(范围2至52岁).MDS65例,其中53例原发性,12例系继发于恶性肿瘤的化疗和/或放疗后.S-AML30例,其中17例由MDS转化而来,12例继发于放疗和化疗,1例有苯接触史.MDS从诊断到移植的中位时间为7个月(范围1-159个月),而S-AML为4个月(0.5-65个月).74例供者为HLA匹配的同胞,3例为同卵双胞胎,1例为HLA半匹配的同胞(两个位点不匹配).在存活的35例中,中位随访时间为27个月(2-91个月).骨髓移植前曾进行强烈化疗的34例中,16例取得完全缓解(S-AML9例,RAEBt 6例,RAEB 1例),10例部分缓解(S-AML,RAEBt,RAEB各3例,CMMoL1例),8例为化
Long-term disease-free survival after intensive chemotherapy in patients with myelodysplastic syndrome (MDS) is disappointing, and Allo-BMT has been an encouraging treatment for patients with MDS, but the literature is limited to a single case report. The European Association of Marrow Leukemia Leukemia Retrospective study of 78 cases of MDS and secondary leukemia (S-AML) allogeneic bone marrow transplantation were retrospectively studied .78 patients from 1981 to 1988 European 21 bone marrow transplant centers 43 males and 35 females with a mean age of 35 years (range, 2 to 52 years) .MDS65 cases, of which 53 cases of primary, 12 cases of secondary malignancy after chemotherapy and / or radiotherapy.S-AML30 Of these, 17 were converted from MDS, 12 were secondary to radiotherapy and chemotherapy, and 1 was benzene-exposed. The median time from diagnosis to transplantation was 7 months (range, 1 to 59 months) S-AML was 4 months (0.5-65 months) .74 donors were HLA-matched siblings, 3 were identical twins and 1 was a HLA-matched sibling (two loci did not match) Of the 35 surviving patients, the median follow-up was 27 months (range, 2-91 months), and of the 34 patients who underwent intensive chemotherapy before bone marrow transplantation, 16 achieved complete remission (9 S-AML, 6 RAEBt, 1 case), 1 0 cases partial remission (S-AML, RAEBt, RAEB in 3 cases, CMMoL1 cases), 8 cases of