Piatkowska-Jakubas Beata, Wolska-Smoleń Teresa, Mensah-Glanowska Patrycja, Hawrylecka Dorota, Szostek Marta, Walter Zbigniew, Skotnicki Aleksander B
Katedra i Klinika Hematologii, Uniwersytet Jagielloński Collegium Medicum w Krakowie.
Przegl Lek. 2011;68(2):78-81.
Multiple myeloma (MM) is one of the hematologic malignancies in which the impact of dose intensity has been demonstrated. In 2005 it was the most common disease for which autologous stem cell transplantation (ASCT) was performed. However, ASCT is not curative, and most patients relapse within a median of 3 years, the introduction of high-dose therapy resulted in prolonged survival. Novel agents such as thalidomide, bortezomib, or lenalidomide have been introduced to improve high-dose therapy outcome. From April 1998 to December 2008, 65 patients with MM underwent in our Department high-dose chemotherapy supported by autologous transplantation of peripheral blood stem cells (APBSCT). Transplantation of progenitor cells was conducted as consolidation of first line treatment in the majority of patients. Double transplantation was performed in 20 patients (31%). Conditioning regimen consisted of high-dose melphalan (200 mg/m2), in the second procedure the dose of melphalan was reduced to 140 mg/m2. Transplant related mortality was not observed. The duration of hematological recovery after first and second transplantation did not differ significantly. At the time of the analysis (June 2009) 51/65 (78.5%) patients are alive, 14/65 (21.5%) died due to disease progression. Median overall survival (OS) and progression free survival ( PFS) obtained were 86 (range 24-128) and 33 (range 4-110) months respectively. This retrospective analysis confirms the efficacy and safety of APBST in multiple myeloma patients.
多发性骨髓瘤(MM)是已证实剂量强度会产生影响的血液系统恶性肿瘤之一。2005年,它是接受自体干细胞移植(ASCT)最常见的疾病。然而,ASCT并非治愈性疗法,大多数患者在中位3年内复发,高剂量疗法的引入使生存期延长。已引入沙利度胺、硼替佐米或来那度胺等新型药物以改善高剂量疗法的效果。1998年4月至2008年12月,我科65例MM患者接受了外周血干细胞自体移植(APBSCT)支持下的高剂量化疗。在大多数患者中,祖细胞移植作为一线治疗的巩固手段进行。20例患者(31%)进行了二次移植。预处理方案包括高剂量美法仑(200mg/m²),在第二次手术中,美法仑剂量降至140mg/m²。未观察到移植相关死亡率。首次和第二次移植后血液学恢复的持续时间无显著差异。在分析时(2009年6月),51/65(78.5%)例患者存活,14/65(21.5%)例患者因疾病进展死亡。获得的中位总生存期(OS)和无进展生存期(PFS)分别为86(范围24 - 128)个月和33(范围4 - 110)个月。这项回顾性分析证实了APBST在多发性骨髓瘤患者中的有效性和安全性。