中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2015年
1期
24-27
,共4页
王婷%刘辉%李江涛%冯茹%田园%邢保利%许晓东%裴蕾%宁尚勇
王婷%劉輝%李江濤%馮茹%田園%邢保利%許曉東%裴蕾%寧尚勇
왕정%류휘%리강도%풍여%전완%형보리%허효동%배뢰%저상용
多发性骨髓瘤%自体外周造血干细胞移植%硼替佐米
多髮性骨髓瘤%自體外週造血榦細胞移植%硼替佐米
다발성골수류%자체외주조혈간세포이식%붕체좌미
multiple myeloma%autologous peripheral stem cell transplantation%bortezomib
目的：对30例多发性骨髓瘤（multiple myeloma，MM）患者经自体外周造血干细胞移植（autologous hematopoietic stem cell transplantation，APBSCT）治疗后的临床疗效进行评估，并分析可能影响预后的因素。方法：30例MM患者有2例复发行2次APBSCT，因此共计移植32例次。移植前予常规联合化疗（11例含万珂），化疗联合G-CSF动员APBSC，选择以马法兰为基础的预处理方案，d0天回输。结果：动员后患者采集的单个核细胞（MNC）中位数为6.41×108/kg，CD34+细胞4.75×106/kg。APBSCT后中位中性粒细胞和血小板重建时间分别为9.5天和11天。APBSCT后CR和VGPR率分别为37.5%和34.4%，中位生存期（overall surviv?al，OS）为67.27个月，中位无进展生存期（progression-free survival，PFS）为29.77个月，其中CR组、PR组中位PFS分别为29个月、20个月，VGPR组中位PFS未达到，CR+VGPR组与PR组PFS比较P=0.025。万珂组和非万珂组CR率分别为63.6%和23.8%（P=0.034），万珂组中位OS及PFS均未达到，非万珂组中位PFS为22个月（P=0.045）。结论：硼替佐米诱导序贯APBSCT可获得更长的无病生存。APBSCT作为MM诱导缓解后的强化治疗，缓解率高，且移植后获得VGPR以上反应的患者PFS获益。
目的：對30例多髮性骨髓瘤（multiple myeloma，MM）患者經自體外週造血榦細胞移植（autologous hematopoietic stem cell transplantation，APBSCT）治療後的臨床療效進行評估，併分析可能影響預後的因素。方法：30例MM患者有2例複髮行2次APBSCT，因此共計移植32例次。移植前予常規聯閤化療（11例含萬珂），化療聯閤G-CSF動員APBSC，選擇以馬法蘭為基礎的預處理方案，d0天迴輸。結果：動員後患者採集的單箇覈細胞（MNC）中位數為6.41×108/kg，CD34+細胞4.75×106/kg。APBSCT後中位中性粒細胞和血小闆重建時間分彆為9.5天和11天。APBSCT後CR和VGPR率分彆為37.5%和34.4%，中位生存期（overall surviv?al，OS）為67.27箇月，中位無進展生存期（progression-free survival，PFS）為29.77箇月，其中CR組、PR組中位PFS分彆為29箇月、20箇月，VGPR組中位PFS未達到，CR+VGPR組與PR組PFS比較P=0.025。萬珂組和非萬珂組CR率分彆為63.6%和23.8%（P=0.034），萬珂組中位OS及PFS均未達到，非萬珂組中位PFS為22箇月（P=0.045）。結論：硼替佐米誘導序貫APBSCT可穫得更長的無病生存。APBSCT作為MM誘導緩解後的彊化治療，緩解率高，且移植後穫得VGPR以上反應的患者PFS穫益。
목적：대30례다발성골수류（multiple myeloma，MM）환자경자체외주조혈간세포이식（autologous hematopoietic stem cell transplantation，APBSCT）치료후적림상료효진행평고，병분석가능영향예후적인소。방법：30례MM환자유2례복발행2차APBSCT，인차공계이식32례차。이식전여상규연합화료（11례함만가），화료연합G-CSF동원APBSC，선택이마법란위기출적예처리방안，d0천회수。결과：동원후환자채집적단개핵세포（MNC）중위수위6.41×108/kg，CD34+세포4.75×106/kg。APBSCT후중위중성립세포화혈소판중건시간분별위9.5천화11천。APBSCT후CR화VGPR솔분별위37.5%화34.4%，중위생존기（overall surviv?al，OS）위67.27개월，중위무진전생존기（progression-free survival，PFS）위29.77개월，기중CR조、PR조중위PFS분별위29개월、20개월，VGPR조중위PFS미체도，CR+VGPR조여PR조PFS비교P=0.025。만가조화비만가조CR솔분별위63.6%화23.8%（P=0.034），만가조중위OS급PFS균미체도，비만가조중위PFS위22개월（P=0.045）。결론：붕체좌미유도서관APBSCT가획득경장적무병생존。APBSCT작위MM유도완해후적강화치료，완해솔고，차이식후획득VGPR이상반응적환자PFS획익。
Objective:To evaluate the clinical efficiency and prognostic factors of autologous peripheral blood stem cell trans-plantation (APBSCT) in 30 cases of multiple myeloma (MM). Methods:Two of the 30 patients received the second treatment of APB-SCT because of relapse after the first treatment. Thus, a total of 32 case-times of APBSCT were studied. Combination chemotherapy was inducted regularly before APBSCT (11 patients used bortezomib as an induction drug), and chemotherapy combined with the G-CSF regimen was used to mobilize peripheral blood stem cells. Preconditioning was based on melphalan. Results:Mononuclear cells in harvest were 6.41 × 108/kg, and CD34+cells in harvest were 4.75 × 106/kg. The median times of neutrophil and platelet engraftment were 9.5 and 11 d, respectively. The complete remission (CR) and very good partial remission (VGPR) rates were 37.5%and 34.4%af-ter APBSCT, respectively. The median overall survival (OS) was 67.27 months in all patients, and the median progression-free survival (PFS) was 29.77 months. The median PFS rates were 29 and 20 months in the patients who achieved CR and PR, respectively, and the median PFS was not observed in the patients who achieved VGPR. Statistical differences in PFS were detected between the CR+VGPR and PR groups (P=0.025). The CR rates were 63.6%and 23.8%in the bortezomib (bortezomib-based chemotherapy) and non-bortezo-mib groups (P=0.034), respectively. The median OS and PFS were not obtained in the bortezomib group, whereas the median PFS was 22 months in the non-bortezomib group (P=0.045). Conclusion: MM patients treated with bortezomib-based chemotherapy followed by APBSCT had prolonged PFS. APBSCT can improve the response and survival of MM patients.
