Allogeneic bone marrow transplantation for leukamia

概要

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The probability of long term survival for allogeneic graft patients was 67% for ALL, 62% for ANL and 61% for CML in the 1 st remission or 1 st chronic phase of each leukemia. The major causes of death were interstitial pneumonia, relapse and infection. On relationship of GVHD and the long term survival, the probability of 5 years survival was 41%, 60% and 33% in grade 0, I and II_??_IV of acute GVHD respectively and it was 70% with chronic GVHD and 40% without. The difference might be due to that of relapse rate of leukemia. This may suggest that GVHD both acute and chronic might have an ability that can suppress the relapse of leukemia, i.e. GVL reaction. Interstitial pneumonia occured in 35% of allograft patients and was often lethal complication (70%). Among many of prophylaxis tested, the followings were effective, a lower dose rate of total body irradiation, the selection of CMV-seronegative platelets donor, and the prophylactic administration of anti-CMV high titer globulin. Colony stimulating facter of human urine was also effective for shortening the granulopenic period after transplantation to prevent severe infections.
日本臨床免疫学会の論文