串联自体干细胞移植和对移植反应对多发性骨髓瘤结果的影响。
Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma.
机构信息
Service of Clinical Hematology, Hospital São João, Porto, Portugal.
出版信息
Exp Hematol Oncol. 2012 Nov 26;1(1):35. doi: 10.1186/2162-3619-1-35.
BACKGROUND
Multiple Myeloma (MM) is the commonest indication for autologous stem cell transplantation (ASCT).
METHODS
We retrospectively analysed data from 85 patients with MM submitted to ASCT in our centre from 2000 to 2010: 132 ASCT were realized, 80 of them as tandem.
RESULTS
After induction, 17.6% were in complete remission (CR), 41.2% in very good partial remission (VGPR) and 41.2% in partial remission (PR). After transplant 44.7% were in CR, 15.3% in VGPR and 40% in PR. With 22 months (range - 3 to 117 months) of median follow-up, median overall survival (OS) was 43 months and progression-free survival (PFS) 22 months. At 5 years, OS was 45.3% (36.7-53.9%, 95%) and PFS 24.5% (18-31%, 95%). Patients with CR after ASCT had significantly longer PFS as compared to patients with PR (27 vs 7 months; p = 0.034) but not when compared to patients with VGPR (27 vs 19 months, p = 0.485). The tandem approach represented an advantage in OS and PFS when compared to only one ASCT (31 vs 19 months - p = 0.018, and 40 vs 31 - p = 0.04, respectively).
CONCLUSIONS
Our results highlight the impact of response to transplant in patients PFS and tandem modality showed to carry better PFS and OS then the single transplant.
背景
多发性骨髓瘤（MM）是自体干细胞移植（ASCT）最常见的适应证。
方法
我们回顾性分析了 2000 年至 2010 年在我们中心接受 ASCT 的 85 例 MM 患者的数据：共进行了 132 次 ASCT，其中 80 次为串联移植。
结果
诱导后，17.6%的患者达到完全缓解（CR），41.2%的患者达到非常好的部分缓解（VGPR），41.2%的患者达到部分缓解（PR）。移植后，44.7%的患者达到 CR，15.3%的患者达到 VGPR，40%的患者达到 PR。中位随访时间为 22 个月（范围为 3 至 117 个月），中位总生存期（OS）为 43 个月，无进展生存期（PFS）为 22 个月。在 5 年时，OS 为 45.3%（36.7-53.9%，95%），PFS 为 24.5%（18-31%，95%）。与 PR 患者相比，ASCT 后达到 CR 的患者 PFS 显著延长（27 个月比 7 个月；p=0.034），但与 VGPR 患者相比无差异（27 个月比 19 个月，p=0.485）。与单次 ASCT 相比，串联移植在 OS 和 PFS 方面均具有优势（31 个月比 19 个月-p=0.018，40 个月比 31 个月-p=0.04）。
结论
我们的结果强调了移植后反应对患者 PFS 的影响，串联移植方式显示出比单次移植更好的 PFS 和 OS。
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