Department of Pharmacy, South Texas Veterans Healthcare System, San Antonio, TX, USA.
Leuk Lymphoma. 2009 Sep;50(9):1442-7. doi: 10.1080/10428190903085936.
Toxicity associated with a second autologous peripheral blood stem cell transplant (APBSCT) in patients who relapse following initial APBSCT for multiple myeloma (MM) has not been well described. We conducted a retrospective, case-series of 25 consecutive patients who received a second APBSCT for relapsed or progressive disease following prior APBSCT to describe associated toxicity. Grade 3 or 4 toxicities were observed in 92% of patients after each APBSCT. More patients developed an elevated serum creatinine (4%vs. 36%; p = 0.011) following the second APBSCT. Median time to neutrophil engraftment was 10 days following both transplants (p = 0.428). Platelet engraftment was delayed by 2 days after the second APBSCT (median 12 vs.14 days; p < 0.025). There were two deaths before day 100. In conclusion, patients who undergo a second APBSCT for relapsed MM experience more nephrotoxicity. Delayed platelet engraftment and an 8% treatment-related mortality were observed following the second APBSCT.
在多发性骨髓瘤（MM）患者首次自体外周血干细胞移植（APBSCT）后复发时，与第二次 APBSCT 相关的毒性尚未得到很好的描述。我们进行了一项回顾性、连续病例系列研究，共纳入 25 例在首次 APBSCT 后复发或进展的患者，以描述相关毒性。在每一次 APBSCT 后，有 92%的患者出现 3 级或 4 级毒性。更多的患者在第二次 APBSCT 后出现血清肌酐升高（4%对 36%；p = 0.011）。两次移植后中性粒细胞植入的中位时间均为 10 天（p = 0.428）。第二次 APBSCT 后血小板植入延迟了 2 天（中位数 12 对 14 天；p < 0.025）。有两名患者在第 100 天前死亡。总之，接受第二次 APBSCT 治疗复发 MM 的患者经历更多的肾毒性。第二次 APBSCT 后观察到血小板植入延迟和 8%的治疗相关死亡率。
