Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeollanamdo, Republic of Korea.
Int J Hematol. 2013 Jan;97(1):92-7. doi: 10.1007/s12185-012-1237-0. Epub 2012 Dec 12.
The CTD (cyclophosphamide, thalidomide, and dexamethasone) regimen is known to be an effective primary therapy in patients with newly diagnosed multiple myeloma (MM). However, stem cell yields after CTD remain inconsistent. The aim of the present study is to identify the influence of the CTD regimen on the outcome of peripheral blood stem cell (PBSC) collection. Fifty-four patients received four cycles of CTD, and PBSCs were mobilized with cyclophosphamide and G-CSF or with G-CSF alone. Each patient from whom ≤4.0 × 10(6) CD34(+) cells/kg were collected received a second mobilization course. The median duration from the start of a CTD regimen to the first collection was 4.3 months. Forty-eight patients were mobilized with cyclophosphamide followed by G-CSF, and six patients were mobilized with G-CSF alone. The median day of apheresis was day 3 (range day 2-day 5). The overall response rate at mobilization was 96.3 %, including 11.1 % complete response, 22.2 % very good partial response, and 63.0 % partial response. The median number of harvested CD34(+) cells was 12.8 × 10(6) cells/kg. At the second mobilization, 88.9 % of patients reached the minimal stem cell collection target of ≥2.0 × 10(6) cells/kg, and 75.9 % of patients achieved the collection target of ≥4.0 × 10(6) cells/kg. CTD within four cycles is an effective primary therapy in patients with newly diagnosed MM and only minimally affects subsequent PBSC collection.
CTD（环磷酰胺、沙利度胺和地塞米松）方案已知是新诊断多发性骨髓瘤（MM）患者的有效一线治疗方法。然而，CTD 后的干细胞产量仍不一致。本研究旨在确定 CTD 方案对外周血干细胞（PBSC）采集结果的影响。54 例患者接受了 4 个周期的 CTD，并用环磷酰胺和 G-CSF 或单用 G-CSF 动员 PBSC。从每位采集≤4.0×10^6 CD34+细胞/kg 的患者中采集第二次动员疗程。从 CTD 方案开始到第一次采集的中位时间为 4.3 个月。48 例患者用环磷酰胺加 G-CSF 动员，6 例患者单用 G-CSF 动员。单采的中位日期为第 3 天（范围第 2-5 天）。动员时的总反应率为 96.3%，包括 11.1%完全缓解，22.2%非常好的部分缓解和 63.0%部分缓解。采集的 CD34+细胞中位数为 12.8×10^6 细胞/kg。在第二次动员中，88.9%的患者达到了≥2.0×10^6 细胞/kg 的最小干细胞采集目标，75.9%的患者达到了≥4.0×10^6 细胞/kg 的采集目标。四个周期内的 CTD 是新诊断 MM 患者的有效一线治疗方法，仅对随后的 PBSC 采集有轻微影响。
