MARROW TRANSPLANTATION FOR MYELODYSPLASIA

骨髓增生异常的骨髓移植

• 批准号: 3780529
• 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/3780529
• 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 middle age (35-64); 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.

先前的骨髓移植治疗骨髓增生异常（MDS）的研究 在西雅图进行的研究表明，使用环磷酰胺 (Cy) 加 12 Gy全身照射（TBI），45%的患者实现长期 无病生存。 对于没有多余原始细胞的患者，移植- 相关毒性是失败的最常见原因，而在 原始细胞过多的患者复发是最常见的问题。 在这个 项目中，我们建议在没有多余原始细胞的 MDS 患者中进行测试， 用白消安 (Bu) 替代 TBI 是否可以减少移植- 相关死亡率而不导致复发频率增加。 在 对于具有过量原始细胞的 MDS 患者，我们计划研究是否 Bu与Cy和TBI相结合的准备方案可以减少 复发率而不增加中毒性死亡。 以前很多 MDS 患者被判定不适合骨髓移植 移植要么是因为年龄，要么是因为他们缺乏 合适的捐赠者。 在本提案中，我们计划探索骨髓 65岁以下患者和使用药物的患者进行MDS移植 无关匹配或部分匹配的捐赠者。