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干细胞移植后多发性骨髓瘤反应的长期预后意义。

Long-term prognostic significance of response in multiple myeloma after stem cell transplantation.

机构信息

Hospital Universitario 12 de Octubre, Madrid, Spain.

出版信息

Blood. 2011 Jul 21;118(3):529-34. doi: 10.1182/blood-2011-01-332320. Epub 2011 Apr 11.


DOI:10.1182/blood-2011-01-332320
PMID:21482708
Abstract

For establishing the true effect of different response categories in patients with multiple myeloma (MM) treated with autologous stem cell transplantation, we evaluated, after a median follow-up of 153 months, 344 patients with MM who received a transplant between 1989 and 1998. Overall survival (OS) at 12 years was 35% in complete response (CR) patients, 22% in near complete response (nCR), 16% in very good partial response (VGPR), and 16% in partial response (PR) groups. Significant differences in OS and progression-free survival were found between CR and nCR groups (P = .01 and P = .002, respectively), between CR and VGPR groups (P = .0001 and P = .003), or between CR and PR groups (P = .003 and P = < 10(-5)); no differences were observed between the nCR and VGPR groups (P = .2 and P = .9) or between these groups and the PR group (P = .1 and P = .8). A landmark study found a plateau phase in OS after 11 years; 35% patients in the CR group and 11% in the nCR+VGPR+PR group are alive at 17 years; 2 cases had relapsed in the nCR+VGPR+PR group. In conclusion, MM achieving CR after autologous stem cell transplantation is a central prognostic factor. The relapse rate is low in patients with > 11 years of follow-up, possibly signifying a cure for patients in CR.

摘要

为了确定自体干细胞移植治疗多发性骨髓瘤(MM)患者不同反应类别的确切效果,我们对 1989 年至 1998 年期间接受移植的 344 例 MM 患者进行了中位随访 153 个月后评估。完全缓解(CR)患者的 12 年总生存率(OS)为 35%,接近完全缓解(nCR)组为 22%,非常好的部分缓解(VGPR)组为 16%,部分缓解(PR)组为 16%。CR 与 nCR 组(P =.01 和 P =.002)、CR 与 VGPR 组(P =.0001 和 P =.003)或 CR 与 PR 组(P =.003 和 P < 10(-5))之间的 OS 和无进展生存期存在显著差异;nCR 与 VGPR 组之间(P =.2 和 P =.9)或这些组与 PR 组之间(P =.1 和 P =.8)无差异。一项里程碑式研究发现,OS 在 11 年后出现平台期;CR 组 35%的患者和 nCR+VGPR+PR 组 11%的患者在 17 年后仍存活;nCR+VGPR+PR 组有 2 例复发。总之,自体干细胞移植后达到 CR 的 MM 是一个重要的预后因素。在随访 11 年以上的患者中,复发率较低,这可能意味着 CR 患者已治愈。

相似文献

[1]
Long-term prognostic significance of response in multiple myeloma after stem cell transplantation.

Blood. 2011-4-11

[2]
Long-term results in multiple myeloma after high-dose melphalan and autologous transplantation according to response categories in the era of old drugs.

Clin Lymphoma Myeloma Leuk. 2014-4

[3]
Retrospective analysis of the efficacy and influencing factors of autologous hematopoietic stem cell transplantation for multiple myeloma.

Artif Organs. 2019-5-20

[4]
[Efficacy and Influencing Factors of Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: Retrospective Analysis].

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018-10

[5]
Autologous stem cell transplantation in first remission is associated with better progression-free survival in multiple myeloma.

Ann Hematol. 2018-5-21

[6]
[Treatment options and prognosis in newly diagnosed multiple myeloma patients].

Zhonghua Xue Ye Xue Za Zhi. 2011-5

[7]
Autologous transplantation in multiple myeloma: a GITMO retrospective analysis on 290 patients. Gruppo Italiano Trapianti di Midollo Osseo.

Haematologica. 1999-9

[8]
Complete remission status before autologous stem cell transplantation is an important prognostic factor in patients with multiple myeloma undergoing upfront single autologous transplantation.

Biol Blood Marrow Transplant. 2009-4

[9]
Achievement of at least very good partial response is a simple and robust prognostic factor in patients with multiple myeloma treated with high-dose therapy: long-term analysis of the IFM 99-02 and 99-04 Trials.

J Clin Oncol. 2009-12-1

[10]
[The efficacy and safety of bortezomib-based induction regimen before autologous hematopoietic stem cell transplantation in patients with multiple myeloma].

Zhonghua Nei Ke Za Zhi. 2012-4

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Cancers (Basel). 2025-1-22

[2]
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Stat Med. 2025-2-10

[3]
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[4]
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Leukemia. 2024-10

[5]
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J Inflamm Res. 2023-12-5

[6]
High serum miR-223-3p expression level predicts complete response and prolonged overall survival in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation.

Front Oncol. 2023-9-27

[7]
Impact of interval progression before autologous stem cell transplant in patients with multiple myeloma.

Front Oncol. 2023-7-24

[8]
Outcomes of young adults (aged ≤ 40 years) with newly diagnosed multiple myeloma after up-front autologous stem cell transplant.

Br J Haematol. 2023-8

[9]
Laboratory and Clinical Settings of Heavy/Light Chain (HLC) Assays in the Management of Monoclonal Gammopathies and Multiple Myeloma.

J Pers Med. 2023-4-27

[10]
Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma.

Cancers (Basel). 2023-3-2

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