Bone marrow transplantation as a treatment for bone cancer

In recent years, the number of bone cancer patients has increased, causing social panic. In order to reduce this panic, we should have a deeper understanding of the treatment of bone cancer. Although modern chemotherapy can significantly prolong the survival of osteosarcoma patients, it cannot cure the disease. Bone marrow transplantation has developed into an important treatment for this disease.

(1) The conditioning regimen often uses high-dose MELC10-140 mg/m2 and systemic radiotherapy (TBI, 8.0-12.0 Gy). The TBC regimen without TBI (TSPA, 750 mg/rn; BllS, 10 mg/kg; CTX, 12 g/kg) can also be used.

(2) Allogeneic bone marrow transplantation According to reports from Europe and the United States, a group of 101 allogeneic bone marrow transplants (allo-BMT) were performed, 50% to 75% of which were high-risk, refractory patients. The median time from diagnosis to transplantation was 19 to 20 months. As a result, 61% achieved complete remission, with a median remission period of 48 to 60 months, a 3-year disease-free survival rate of 40%, and a transplant-related mortality rate of 16%. In 1995, Barlogie conducted a comprehensive analysis of the data of 268 cases of allo-BMT treatment for MM, with a CR rate of 35%, a 5-year disease-free survival rate of 35%, and a transplant-related mortality rate of up to 40%. It is generally believed that allo-BMT has a good effect on early MM that is sensitive to chemotherapy and has a short time from diagnosis to transplantation. The main limiting factors are age and marrow donors (only a small number of patients are eligible for allo-BMT).

(3) Autologous hematopoietic stem cell transplantation Large-sample clinical studies have confirmed that autologous hematopoietic stem cell transplantation (ASCT) can effectively improve the CR rate of MM and prolong survival time. ASCT includes autologous bone marrow transplantation (ABMT) and autologous peripheral blood hematopoietic stem cell transplantation. Generally, bone marrow is collected after chemotherapy kills a large number of tumor cells and the hematopoietic function of the bone marrow is in the recovery stage. IID-CTX (6.0g/m2) + G-CSF is used as a mobilizing agent, and peripheral hematopoietic stem cells are collected by a blood cell separator.

Eight centers in Europe and the United States used AS (first-line treatment for 571 cases. The time from diagnosis to transplantation of osteosarcoma was mostly within 12 months, with a median age of 50 years, a median follow-up of 24 months, a CR rate of 42% (22%-77%), a median disease-free survival of 30 months, and a transplant-related mortality of 5%. The long-term efficacy of PBSCT and ABMT was similar. The 132-MG level before transplantation, sensitivity to chemotherapy, and efficacy after transplantation were the main factors affecting long-term survival.

The main issues of ASCT are:

① The current pretreatment regimen is difficult to completely eliminate tumor cells in the body.

② The infused bone marrow or PGC contains tumor cells. Both are the reasons for the high relapse rate after ASCT. In vitro positive selection of CD4+ PBSC can reduce tumor cells by 2.7-4.5 logarithmic levels, and the in vitro purification effect of monoclonal antibodies is still uncertain.

The above is the treatment of bone marrow transplantation. Experts suggest: If your health has symptoms of disease, you can choose the appropriate treatment according to your symptoms, but do not delay diagnosis, and do not let your life be ruined in hesitation. You should go to a regular hospital for treatment in time to avoid delaying the disease and causing serious consequences. If you have other questions, please consult our online experts or call for consultation. Believe in miracles, and wish you health, happiness, and joy!

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