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对于不是处在第一次完全缓解的急性白血病和不再处于慢性期的慢性粒细胞白血病病人进行骨髓移植后,原发肿瘤的复发是治疗失败的主要原因。这类病人经全身照射(TBI)和大剂量环磷酰胺组成的方案做预处理后进行骨髓移植,无病生存率在10～40%之间。为了不增加毒性作用和减少肿瘤复发,作者采用了 TBI 和大剂量鬼臼乙叉甙(etoposide,VP16-213)作为骨髓移植前预处理方案。鬼臼乙叉甙具有独特的骨髓毒性作用,已证明它对复发性血液系统的恶性肿瘤有效,且静脉使用大剂量可渗入脑脊液中。
Recurrence of the primary tumor is the primary cause of failure after bone marrow transplantation in patients with acute leukemia who are not in complete remission for the first time and chronic myeloid leukemia who are no longer in chronicity. These patients underwent whole-body irradiation (TBI) and high-dose cyclophosphamide regimen composed of bone marrow transplantation after pre-treatment, disease-free survival rate of 10 to 40%. In order not to increase the toxic effect and reduce tumor recurrence, the authors used TBI and a large dose of etoposide (VP16-213) as a pretreatment program for bone marrow transplantation. Etoposide has a unique myelotoxic effect that has been shown to be effective in the treatment of malignant tumors of the recurrent hematological malignancies and intravenous use of large doses to infiltrate cerebrospinal fluid.