Gahrton G, Svensson H, Cavo M, Apperly J, Bacigalupo A, Björkstrand B, Bladé J, Cornelissen J, de Laurenzi A, Facon T, Ljungman P, Michallet M, Niederwieser D, Powles R, Reiffers J, Russell N H, Samson D, Schaefer U W, Schattenberg A, Tura S, Verdonck L F, Vernant J P, Willemze R, Volin L
Department of Medicine, Huddinge Hospital, Sweden.
Br J Haematol. 2001 Apr;113(1):209-16. doi: 10.1046/j.1365-2141.2001.02726.x.
Out of 690 allogeneic matched sibling donor transplants for multiple myeloma reported to the European Group for Blood and Marrow Transplantation (EBMT) registry, 334 were performed during the period 1983-93 (all with bone marrow) and 356 during 1994-98 [223 with bone marrow and 133 with peripheral blood stem cells (PBSCs)]. The median overall survival was 10 months for patients transplanted during the earlier time period and 50 months for patients transplanted with hone marrow during the later period. The use of PBSCs was associated with earlier engraftment but no significant survival benefit compared to bone marrow transplants during the same time period. The improvement in survival since 1994 with the result of a significant reduction in transplant-related mortality, which was 38%, 21% and 25% at 6 months and 46%, 30% and 37% at 2 years during the earlier period, and the later period with bone marrow and PBSCs respectively. Reasons for the reduced transplant-related mortality appeared to be fewer deaths owing to bacterial and fungal infections and interstitial pneumonitis, in turn a result of earlier transplantation and less prior chemotherapy. Better supportive treatment and more frequent use of cytokines may also play a role. The improvement in survival was not directly related to the increased use of PBSCs.
在向欧洲血液和骨髓移植组（EBMT）登记处报告的690例用于多发性骨髓瘤的全相合同胞供体移植中，1983 - 1993年期间进行了334例（均为骨髓移植），1994 - 1998年期间进行了356例[223例为骨髓移植，133例为外周血干细胞（PBSC）移植]。早期移植患者的中位总生存期为10个月，后期接受骨髓移植的患者为50个月。与同期骨髓移植相比，使用PBSC与更早的植入相关，但无显著的生存获益。自1994年以来生存率有所提高，移植相关死亡率显著降低，早期6个月时为38%、21%和25%，2年时为46%、30%和37%，后期骨髓移植和PBSC移植时分别为上述对应数值。移植相关死亡率降低的原因似乎是由于细菌和真菌感染及间质性肺炎导致的死亡减少，这反过来是早期移植和前期化疗较少的结果。更好的支持治疗和更频繁地使用细胞因子可能也起了作用。生存率的提高与PBSC使用增加并无直接关联。
