Amyloid Treatment and Research Program, Boston University School of Medicine, Boston, MA 02118, USA.
Ann Hematol. 2010 Jun;89(6):579-84. doi: 10.1007/s00277-009-0874-8. Epub 2009 Dec 10.
High-dose melphalan chemotherapy and autologous peripheral blood stem cell transplantation (HDM/SCT) has been shown to result in a durable hematologic response and prolonged overall survival in systemic amyloid light-chain (AL) amyloidosis as well as multiple myeloma. However, little is known about the myeloma associated with AL amyloidosis (MM/AL). In this retrospective study, we evaluated 87 patients with MM/AL from 1994 to 2007. Sixteen of these patients underwent HDM/SCT at Boston University Medical Center. Three patients (19%) died from treatment-related mortality. The overall median survival for all 87 patients was 22 months by Kaplan-Meier estimates. However, this was improved to 54.5 months for those who received HDM/SCT compared to 21 months for those who did not receive HDM/SCT. A hematologic complete response was achieved by 25% (4/16) of patients at 6 months after HDM/SCT. Hematologic relapses occurred in 60% of patients at a median of 1 year after HDM/SCT. In conclusion, HDM/SCT can prolong overall survival in patients with MM/AL who are eligible to receive it.
高剂量马法兰化疗和自体外周血干细胞移植（HDM/SCT）已被证明可在系统性轻链（AL）淀粉样变性和多发性骨髓瘤中产生持久的血液学反应和延长总生存期。然而，对于与 AL 淀粉样变性相关的骨髓瘤（MM/AL）知之甚少。在这项回顾性研究中，我们评估了 1994 年至 2007 年期间 87 例 MM/AL 患者。这些患者中有 16 例在波士顿大学医学中心接受了 HDM/SCT。3 例（19%）患者死于治疗相关死亡率。通过 Kaplan-Meier 估计，所有 87 例患者的总中位生存期为 22 个月。然而，对于接受 HDM/SCT 的患者，这一数字提高到 54.5 个月，而未接受 HDM/SCT 的患者为 21 个月。在接受 HDM/SCT 后 6 个月，25%（4/16）的患者达到了血液学完全缓解。血液学复发发生在 HDM/SCT 后中位时间为 1 年的 60%的患者中。总之，对于有资格接受 HDM/SCT 的 MM/AL 患者，HDM/SCT 可以延长总生存期。
