Mohty M, Richardson P G, McCarthy P L, Attal M
1] Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, APHP, Paris, France [2] Universite Pierre et Marie Curie, Paris, France [3] INSERM, UMRs 938, Paris, France.
Department of Medical Oncology, Dana-Farber Cancer Institute, Jerome Lipper Multiple Myeloma Center, Boston, MA, USA.
Bone Marrow Transplant. 2015 Aug;50(8):1024-9. doi: 10.1038/bmt.2015.83. Epub 2015 Apr 20.
Novel agents including proteasome inhibitors and immunomodulatory drugs are now routinely utilized as part of the induction regimen before transplantation and this has resulted in substantial improvements in the depth of response achieved before transplant. Given that depth of response is prognostic for overall outcome, a number of studies have been conducted or are ongoing to investigate the use of novel agents as consolidation and maintenance therapy after transplant. Most clinical trials have reported after consolidation and maintenance therapy an increased PFS and even overall survival in some of them. The use of post-autologous stem cell transplant consolidation and maintenance is an increasingly attractive concept. However, some side effects could be observed with such long-term therapy and many open questions are still under debate. The decision to administer consolidation and/or maintenance therapy will likely need to be guided by the individual patient situation. This review aims to analyze the currently available research evidence in this field.
包括蛋白酶体抑制剂和免疫调节药物在内的新型药物目前已被常规用作移植前诱导方案的一部分，这使得移植前达到的缓解深度有了显著改善。鉴于缓解深度对总体预后具有预后价值，已经开展了一些研究或正在进行研究，以探讨新型药物在移植后作为巩固和维持治疗的应用。大多数临床试验报告称，在巩固和维持治疗后，无进展生存期有所延长，其中一些试验甚至报告了总生存期的延长。自体干细胞移植后巩固和维持治疗的应用是一个越来越有吸引力的概念。然而，这种长期治疗可能会观察到一些副作用，许多悬而未决的问题仍在讨论中。给予巩固和/或维持治疗的决定可能需要根据个体患者的情况来指导。本综述旨在分析该领域目前可用的研究证据。
