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自体造血干细胞移植治疗多发性骨髓瘤53例的疗效评价及预后因素分析
Efficacy and prognostic factors of autologous hematopoietic stem cell transplantation for multiple myeloma: clinical analysis of 53 cases
- 第三军医大学学报 2021年43卷第6期 页码：553-559
- 作者机构：
- 作者简介：
- 基金信息：重庆市科卫联合医学科研重点项目(2018ZDXM001)
DOI：10.16016/j.1000-5404.202010015
中图分类号：收稿：2020-10-09，
纸质出版：2021-03-30
- 稿件说明：
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何人可, 王欣, 罗小华, 等. 自体造血干细胞移植治疗多发性骨髓瘤53例的疗效评价及预后因素分析[J]. 第三军医大学学报, 2021,43(6):553-559.
Renke HE, Xin WANG, Xiaohua LUO, et al. Efficacy and prognostic factors of autologous hematopoietic stem cell transplantation for multiple myeloma: clinical analysis of 53 cases[J]. Journal of Third Military Medical University, 2021, 43(6): 553-559.
何人可, 王欣, 罗小华, 等. 自体造血干细胞移植治疗多发性骨髓瘤53例的疗效评价及预后因素分析[J]. 第三军医大学学报, 2021,43(6):553-559. DOI： 10.16016/j.1000-5404.202010015.
Renke HE, Xin WANG, Xiaohua LUO, et al. Efficacy and prognostic factors of autologous hematopoietic stem cell transplantation for multiple myeloma: clinical analysis of 53 cases[J]. Journal of Third Military Medical University, 2021, 43(6): 553-559. DOI： 10.16016/j.1000-5404.202010015.
摘要
Abstract
Objective
2
To evaluate the efficacy of autologous hematopoietic stem cell transplantation (auto-HSCT) on multiple myeloma (MM) and to investigate the factors affecting the prognosis.
Methods
2
The clinical data of 53 MM patients treated with auto-HSCT in our hospital from January 2010 to December 2019 were collected and retrospectively analyzed. The therapeutic effect was observed and the prognostic factors were analyzed.
Results
2
Hematopoietic reconstruction was achieved in all 53 patients
and no transplant-related death occurred. As complete remission (CR) and very good partial remission (VGPR) were defined as effective response
the rate was 84.9% after transplantation
significantly higher than that before treatment (52.8%)(
P
<
0.001). The effective remission rates were 52.2% and 84.8%
respectively
before and after treatment in the 46 patients with single transplantation (
P
=0.001). However
the rates were 57.1% and 85.7% respectively for the 7 patients with consecutive double transplantation (
P
=0.559). There were no significant differences in progression-free survival (PFS) and overall survival (OS) between the single and continuous double transplantation patients (
P
>
0.05). Influential factors for poor prognosis were identified as: age≥50 years
stage Ⅲ by revised international staging system (R-ISS)
time from diagnosis to transplantation ≥180 d
high-risk stratification
partial remission (PR) or worse before and after transplantation
as well as positive results of minimal residual disease (MRD) test before and after treatment.
Conclusion
2
Auto-HSCT is safe and effective in MM patients
and can significantly improve the remission rate and prognosis. Single transplantation is better than continuous double treatment in the effectiveness. R-ISS stage
risk stratification
disease status before and after transplantation
and result of MRD test are closely associated with the prognosis of the patients.
关键词
Keywords
references
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