CAJ | 학술논문

背景:自体外周血造血干细胞移植联合大剂量化疗能明显提高多发性骨髓瘤患者完全缓解率和生存率,但复发率较高.硼替佐米是26S蛋白酶体抑制剂,对初治多发性骨髓瘤具有显著疗效.目的:评价自体外周血造血干细胞移植联合硼替佐米及大剂量美法仑对多发性骨髓瘤患者的疗效.方法:回顾性分析2006-10/2007-05贵阳医学院附属医院血液科收治的3例多发性骨髓瘤患者,均采用化疗加粒细胞集落刺激因子方案进行自体外周血造血干细胞的动员.于移植前3 d静脉滴注美法仑200mg/m~2作为预处理方案,停药48 h后回输白体外周血造血干细胞.结果与结论:3例患者均获造血重建,细胞移植后30 d骨髓抑制恢复正常,骨痛改善.细胞移植后,第1,2例患者获得完全缓解,第3例患者获得部分缓解.提示自体外周血造血干细胞移植联合硼替佐米及大剂量美法仑是治疗多发性骨髓的有效手段,患者对预处理方案耐受性较好.
배경:자체외주혈조혈간세포이식연합대제양화료능명현제고다발성골수류환자완전완해솔화생존솔,단복발솔교고.붕체좌미시26S단백매체억제제,대초치다발성골수류구유현저료효.목적:평개자체외주혈조혈간세포이식연합붕체좌미급대제량미법륜대다발성골수류환자적료효.방법:회고성분석2006-10/2007-05귀양의학원부속의원혈액과수치적3례다발성골수류환자,균채용화료가립세포집락자격인자방안진행자체외주혈조혈간세포적동원.우이식전3 d정맥적주미법륜200mg/m~2작위예처리방안,정약48 h후회수백체외주혈조혈간세포.결과여결론:3례환자균획조혈중건,세포이식후30 d골수억제회복정상,골통개선.세포이식후,제1,2례환자획득완전완해,제3례환자획득부분완해.제시자체외주혈조혈간세포이식연합붕체좌미급대제량미법륜시치료다발성골수적유효수단,환자대예처리방안내수성교호.
BACKGROUND:Autologous peripheral blood hemopoietic stem cell transplantation(HSCT)in combination with high-dose chemotherapy significantly improves complete remission and survival rate of multiple myeloma patients.However,the relapse rate is high.Bortezomib is 26S proteasomes inhibitor,and effective on the primary treatment of multiple myeloma.OBJECTIVE:To evaluate the curative effect of HSCT in combination with bortezomib and high dose-melphalan for multiple myeloma.METHODS:A retrospective analysis of 3 patients with a stage-ITT multiple myeloma admitted to Department of Hematology,Affiliated Hospital of Guiyang Medical College from October 2006 to May 2007,was conducted.Chemotherapy and granulocyte colony-stimulating factor were used to mobilize autologous peripheral blood hemopoietic stem cells.All patients were pretreated with 200 mg/m2 melphalan via intravenous drip 3 days before transplantation,followed by HSCT 48 hours after drug termination.RESULTS AND CONCLUSION:All patients obtained prompt and sustained hematopoietic reconstitution,and bone marrow depression restored 30 days following HSCT.Case 1 and 2 obtained complete remission,and case 3 obtained partial remission.Results show that HSCT in combination with bortezomib and high-dose melphalan is a safe and feasible treatment on multiple myeloma.The patients have good tolerance to pretreatment.