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近年来,成人急性白血病经细胞毒药治疗获得完全缓解的机会日益增多。彻底治愈的最佳方法尚有争议;一些人认为化疗,特别是缓解后用较大剂量细胞毒药(所谓早期强化或巩固治疗)最有可能根治该病;另一些人认为化疗和放疗后,以合适的供体作骨髓移植效果较好。施行骨髓移植需一定条件:①患者需较年青,因年龄较大者并发症,特别是移植物抗宿主病(GVHD)较多见,且较严重;②需 HLA 相同的同胞作为供体;③需使患者知道移植治疗的危险性并愿意接受。移植前的化疗和放疗可以根除缓解期骨髓中残存的白血病细胞和抑制患者的免疫性,以便异体骨髓的移植及存活。移植前受体的准备:应用大剂量细胞毒药,包括 CTX,其后大剂量全身照射。最近资料报告,50～60%移植病人可长期存活或治愈。尽管大部分移植者能经受得起治疗,但仍有复发。异体骨髓移植的
In recent years, the chance of complete remission of adult acute leukemia by cytotoxic treatment has been increasing. The best way to achieve a complete cure is controversial; some believe that chemotherapy, especially after remission with a higher dose of cytotoxic drugs (so-called early strengthening or consolidation therapy) is most likely to cure the disease; others think that after chemotherapy and radiotherapy, Suitable donor for bone marrow transplantation is better. Bone marrow transplantation required certain conditions: ① patients should be younger, due to older complications, especially graft-versus-host disease (GVHD) more common, and more serious; ② HLA HLA-identical siblings as donors; ③ Patients need to be aware of the risk of transplant and are willing to accept it. Pretransplant chemotherapy and radiotherapy can eradicate remnant leukemia cells in the bone marrow and suppress the patient’s immunity in order to allogeneic bone marrow transplantation and survival. Preparation of pre-transplant recipients: Use of high-dose cytotoxic agents, including CTX, followed by high-dose whole-body irradiation. Recent data report, 50 to 60% of transplant patients can be long-term survival or cure. Although most transplanters are able to withstand treatment, there is still a relapse. Allogeneic bone marrow transplantation