Centro de Hematología y Medicina Interna de Puebla, Clinica Ruiz de Puebla, 8B Sur 3710, Colonia Anzures, Puebla, Mexico.
Bone Marrow Transplant. 2009 Dec;44(11):715-9. doi: 10.1038/bmt.2009.71. Epub 2009 Apr 6.
In a 14-year period in a single institution 31 autografts were performed in 26 patients with multiple myeloma (MM), using a simplified and affordable autografting procedure: conducting the grafts on an outpatient basis and avoiding stem cell freezing. Autografts were started on an outpatient basis in all instances, but four patients were admitted to the hospital. Median time to achieve more than 0.5 x 10(9)/l granulocytes was 27 days, whereas median time to recover above 20 x 10(9)/l plts was 37 days. CR was achieved in 19 cases and a very good partial response in 6 cases. The 100-day mortality was 9.6%. The overall median post-transplant survival has not been reached, being above 76 months, whereas the 76-month survival is 80%. The median cost of each procedure was US$ 15 000. Survival results were substantially better than those of historical control in a group of patients treated in the same institution with melphalan/prednisone. It is concluded that high-dose therapy rescued with a simplified autologous stem cell graft is a valid, useful and affordable therapeutic option for patients with MM, even with economical restraints.
在一家机构的 14 年期间，对 26 例多发性骨髓瘤（MM）患者进行了 31 次自体移植，采用了简化且负担得起的自体移植程序：在门诊进行移植，并避免干细胞冷冻。所有情况下均在门诊开始进行自体移植，但有 4 例患者住院。获得超过 0.5 x 10(9)/l 粒细胞的中位时间为 27 天，而恢复超过 20 x 10(9)/l plts 的中位时间为 37 天。19 例达到完全缓解，6 例达到非常好的部分缓解。100 天死亡率为 9.6%。总体中位移植后生存时间尚未达到，超过 76 个月，而 76 个月的生存率为 80%。每次手术的中位费用为 15000 美元。与在同一机构接受马法兰/泼尼松治疗的一组患者的历史对照相比，生存结果明显更好。结论是，用简化的自体干细胞移植进行高剂量治疗是 MM 患者的一种有效、有用且负担得起的治疗选择，即使在经济拮据的情况下也是如此。
