异基因骨髓移植治疗慢性粒细胞性白血病——体外去除和未去除供髓T细胞的临床效果比较

Allogeneic bone marrow transplantation (BMT) in treatment of chronic myeloid leukemia: Comparison of cases with T cell depletion or without it

  • 摘要: 本文报告用异基因骨髓移植治疗慢性粒细胞性白血病30例的结果。其中20例用全T淋巴细胞单克隆抗体去除供髓中的T淋巴细胞,另10例则否。移植结果表明,去除T淋巴细胞移植组的患者移植后GVHD发生率低,缓解持续时间短,ph'染色体阳性细胞复发率高,未去除T淋巴细胞移植组则与之相反(P值分别<0.05、<0.05和<0.02)。

     

    Abstract: Thirty patients (15 males and 15 females, with a median age of 35 years) with chronic myeloid leukemia (CML) in first chronic phase received allogeneic bone marrow transplantation from July 1983 to March 1989. All patients were ph' chromosome positive. They received bone marrow from HLA-identical siblings with negative mixed lymphoid cell culture.
    The conditioning regimen consisted of TBI (10.2-12 Gy in 6 fractions given in 2 days with a dose rate 0.125-0.204 Gy/min) and CTX (60 mg/Kg body weight each day for 2 successive days). In an attempt to prevent GVHD, bone marrow depleted of T cell with Campath-1 monoclonal T-cell antibodies plus cyclosporine A were transplanted to 20 patients. For comparison, the remaining 10 patients received marrow without T cell depletion in combination with cyclosporin A and MTX (day+ 1, 3. 6 and 11).
    The results indicsted that T cell depletion was associated with both beneficial and adverse consequences. The incidence of acute (≥grade 2) and Chronic GVHD was siginilicantly decreased by T-cell depletion (P<0.05 and <0.005, respectively), but ph' chromosome positive cells reappeared more frequently and duration of complete remission was short (P<0.02 and <0.05, respectively). Infections, GVHD and interstitial pneumonitis continued to be the principal causes of death following BMT in patients with leukemia.

     

/

返回文章
返回