MARROW TRANSPLANTATION FOR MYELODYSPLASIA

骨髓增生异常的骨髓移植

• 批准号: 3844477
• 负责人: FREDERICK R APPELBAUM
• 金额: --
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3844477
• 关键词: T lymphocyte; antileukocyte isoantibody; aplastic anemia; artificial immunosuppression; blood disorder chemotherapy; blood donor; bone marrow exam; bone marrow transplantation; busulfan; combination chemotherapy; cyclophosphamide; dyserythropoietic anemia; graft versus host disease; histocompatibility typing; homologous transplantation; human subject; human therapy evaluation; platelet transfusion; postoperative complications; preoperative state; radiation immunosuppression; relapse /recurrence; tissue /cell culture

Previous studies of marrow transplantation for myelodysplasia (MDS) performed in Seattle have shown that using cyclophosphamide (Cy) plus 12 Gy total body irradiation (TBI), 45% of patients achieve long-term disease-free survival. In patients without excess blasts, transplant- related toxicities were the most common reasons for failure, while in patients with excess blasts relapse was the most common problem. In this project, we propose to test, in patients with MDS without excess blasts, whether substitution of busulfan (Bu) for TBI can reduce transplant- related mortality without causing an increase in relapse frequency. In patients with MDS with excess blasts, we plan to study whether a preparative regimen which combines Bu with Cy and TBI can reduce the relapse rate without an increase in toxic deaths. Previously many patients with MDS were judged not to be candidates for marrow transplantation either because of age or because they lacked an appropriate donor. In this proposal, we plan to explore marrow transplantation for Mds in patients up to age 65 and in patients using unrelated matched or partially matched donors.

先前关于骨髓增生（MDS）的骨髓移植的研究 在西雅图进行的表明，使用环磷酰胺（CY）加12 Gy全身照射（TBI），有45％的患者长期实现 无病生存。 在没有过多爆炸的患者中，移植 - 相关毒性是失败的最常见原因，而 过度爆炸复发的患者是最常见的问题。 在这个 项目，我们建议在没有过多爆炸的MDS患者中进行测试， 替代Busulfan（BU）为TBI是否可以减少移植 - 相关死亡率而不会导致复发频率增加。 在 MDS患有过度爆炸的患者，我们计划研究是否 将BU与CY和TBI结合的制备方案可以减少 复发率没有毒性死亡的增加。 以前很多 MD的患者被认为不是骨髓的候选者 移植是因为年龄或缺乏 适当的捐助者。 在此提案中，我们计划探索骨髓 在65岁以下的患者中，MD的移植以及使用的患者 无关匹配或部分匹配的捐助者。