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Knochenmarktransplantation bei Patienten mit Leukämien

Bone marrow transplantation for leukemia in remission

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Summary

Between October 1979 and March 1982, bone marrow transplantations were performed by the Tübingen Group for BMT on 19 patients with acute leukemia in remission and on one patient with chronic myelocytic leukemia in chronic phase. The conditioning regimen consisted of 2×60 mg cyclophosphamide/kg and 10 Gy whole-body irradiation with the linear accelerator. The lung dose was limited by shielding to 8 Gy. In 15 patients, the bone marrow cell suspension of the donor was preincubated with antihuman T-cell globulin (AHTCG) for prophylaxis of graft-versus-host disease (GVHD). All patients showed prompt engraftment of donor cells with good hemopoietic function and complete chimerism. Under reverse isolation in sterile units, no severe bacterial or fungal infections were seen in the phase of bone marrow aplasia.

Twelve in twenty patients survived between 25 and 900 days. A severe GVHD was seen only in two patients — one after preincubation with AHTCG. One patient died from relapse of his leukemia, another patient had a testicular relapse which was treated with local radiotherapy. Major problems were seen with chronic GVHD (six patients) and infectious complications, most importantly interstitial pneumonia, in the late post-transplant period.

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Abbreviations

AHTCG:

Anti-Human-T-Zell-Globulin [11]

ALL:

Akute lymphatische Leukämie

AML:

Akute myeloische Leukämie

AMML:

Akute myelomonozytäre Leukämie

AUL:

Akute undifferenzierte Leukämie

GVHD:

Graftversus-Host-Krankheit

CML:

Chronische myeloische Leukämie

HLA:

Human leukocyte antigen

KMT:

Knochenmarktransplantation

MLC:

„mixed leukocyte culture“

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Herrn Prof. Dr. G.W. Löhr, Freiburg, zum 60. Geburtstag gewidemet

Mit Unterstützung durch die Deutsche Forschungsgemeinschaft, DFG-Forschergruppe „Leukämieforschung“, Wa 139/11-Wa 139/13-5

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Wilms, K., Link, H., Meyer, P. et al. Knochenmarktransplantation bei Patienten mit Leukämien. Klin Wochenschr 60, 1279–1287 (1982). https://doi.org/10.1007/BF01727484

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