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SUSTAINED ENGRAFTMENT OF ALLOGENEIC BONE MARROW TRANSPLANTS IN THREE CASES OF LEUKEMIA

1985年第7期

作者：陆道培郭乃榄殷慧君金能人王家锦王德炳汤慧安家宾丘镜莹田丁江宾单福香

From 1981 through 1983, we performed three allogeneic bone marrow transplants for the treatment of leukemia. They were the first three cases of sustained bone marrow engraftment in China. The sustained engraftment was proven by cytogenetic, isozyme, and blood group analyses. The patients are all well at the time of writing this report. The first patient was a 19-year-old female with acute monocytic leukemia. After she had attained complete remission, she was treated with a protocol including intravenous cyclophosphamide (1.8 g/m~2/day×2) and total body irradiation (TBI) of 600 rads followed by a bone marrow transplant from her brother. MTX and daily intravenous placental Y-globulin were administered after narrow infusion. Although moderate acute and chronic graft versus host disease (GVHD) did occur, they were controlled by treatment. The second patient was a 12-year-old boy with early relapse of acute granulocytic leukemia. He received essentially the same protocol as the first patient. Acute and chronic GVHD, as well as septicemia, occurred after transplanatation but were controlled. The third patient was an adult woman with chronic granulocytic leukemia in the chronic phase. She received essentially the same protocol except that the TBI was 700 rads and much less MTX was given. Her ph~1 chromosome disappeared gradually after bone marrow transplantation. She had mild acute and chronic GVHD, which were controlled. Cytogenetic analysis provided evidence of a graft versus leukemia effect. We hold that intravenous placental Y-globulin in large dosages, which had notpreviously been used in BMT recipients, might help to control GVHD by exerting an immunosuppressive effect through a feedback mechanism.

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