CAJ | 학술논문

目的评价新药诱导后自体造血干细胞移植(ASCT)对荧光原位杂交(FISH)标危及高危多发性骨髓瘤患者生存的影响.方法回顾性分析74例多发性骨髓瘤患者,均接受以硼替佐米和(或)沙利度胺为主的诱导化疗,按FISH检测结果及诱导后是否接受ASCT分为标危移植组、标危化疗组、高危移植组及高危化疗组4组,通过生存分析分别评价ASCT对标危及高危患者生存的影响.结果 74例患者经新药诱导后总缓解率为91.9％(68/74),接近完全缓解(nCR)+完全缓解(CR)率为62.2％(46/74).FISH标危的患者与高危的患者诱导后缓解率分别为93.2％(41/44)与86.7％(26/30) (P=0.592),nCR+CR率分别为56.8％(25/44)与70.0％(21/30) (P=0.251).FISH标危的患者中,接受移植的患者与接受化疗巩固的患者无进展生存(PFS)及总生存(OS)差异均无统计学意义(P值分别为0.642和0.652),而FISH高危的患者中,接受移植的患者比接受化疗巩固的患者PFS延长19.7个月(P=0.028),OS延长12.5个月(P=0.542).结论在以硼替佐米和(或)沙利度胺为主的方案诱导后,ASCT对FISH标危多发性骨髓瘤患者的PFS和OS均没有影响,但可使FISH高危患者的PFS延长.
목적 평개신약유도후자체조혈간세포이식(ASCT)대형광원위잡교(FISH)표위급고위다발성골수류환자생존적영향.방법 회고성분석74례다발성골수류환자,균접수이붕체좌미화(혹)사리도알위주적유도화료,안FISH검측결과급유도후시부접수ASCT분위표위이식조、표위화료조、고위이식조급고위화료조4조,통과생존분석분별평개ASCT대표위급고위환자생존적영향.결과 74례환자경신약유도후총완해솔위91.9％(68/74),접근완전완해(nCR)+완전완해(CR)솔위62.2％(46/74).FISH표위적환자여고위적환자유도후완해솔분별위93.2％(41/44)여86.7％(26/30) (P=0.592),nCR+CR솔분별위56.8％(25/44)여70.0％(21/30) (P=0.251).FISH표위적환자중,접수이식적환자여접수화료공고적환자무진전생존(PFS)급총생존(OS)차이균무통계학의의(P치분별위0.642화0.652),이FISH고위적환자중,접수이식적환자비접수화료공고적환자PFS연장19.7개월(P=0.028),OS연장12.5개월(P=0.542).결론 재이붕체좌미화(혹)사리도알위주적방안유도후,ASCT대FISH표위다발성골수류환자적PFS화OS균몰유영향,단가사FISH고위환자적PFS연장.
Objective To evaluate the impact of autologous hematopoietic stem cell transplantation (ASCT) on survival in standard and high-risk multiple myeloma (MM) patients by FISH.Methods Seventyfour patients were enrolled in this retrospective research and all patients were inducted by bortezomib /thalidomide.Patients were divided into four groups according to FISH-based risk stratification and consolidation strategy.Impact on survival was evaluated through survival analysis.Results The total response rate of all patients was 91.9 ％ (68/74),nCR+CR rate was 62.2 ％ (46/74).No significant difference was found in response rate or nCR+CR rate between standard group and high-risk group (P =0.592,0.251).In high-risk group,PFS and OS were found to be prolonged 19.7 months and 12.5 months respectively in ASCT-group than those in chemo-group (P =0.028,0.542),while no significant difference was found between ASCT-group and chemo-group in standard-risk group.Conclusion After induction therapy with bortezomib / thalidomide,single ASCT has no impact on survival in standard-risk MM patients but prolongs PFS in high-risk group.