Buckner C D, Fefer A, Bensinger W I, Storb R, Durie B G, Appelbaum F R, Petersen F B, Weiden P, Clift R A, Sanders J E
Eur J Haematol Suppl. 1989;51:186-90. doi: 10.1111/j.1600-0609.1989.tb01515.x.
28 patients with plasma cell malignancies received marrow transplants from identical twins (N = 8), HLA-identical family members (N = 15), HLA partially-matched relatives (N = 3) or cryopreserved autologous marrow (N = 2). Treatment regimens included cyclophosphamide (CY) and total body irradiation (TBI) for 15 patients and busulphan (BU) and CY for 13 patients. 3 of 8 twins are alive, 2 without disease at 24 and 34 months, and 1 is alive and well at 116 months without evidence of disease except for at small residual monoclonal protein spike. 12 of the 18 allografted patients died of transplant-related causes and 2 died of progressive disease. 4 of 18 allograft recipients are alive; 2 are free of disease at 16 and 15 months, 1 is alive at 6 months without disease except for persistent monoclonal Kappa protein. 1 patient is alive with residual marrow involvement and a persistent IGA lambda monoclonal protein at 7 months. 1 of the 2 autograft recipients is alive 2 months after transplant and is not yet evaluable for tumor response and the other patient died early of transplant-related complications. Both CY + TBI and BU + CY resulted in remissions in patients with advanced plasma cell malignancies. However, the optimal treatment regimen and timing of transplantation remain to be determined.
28例浆细胞恶性肿瘤患者接受了骨髓移植，供体分别为同卵双胞胎（8例）、HLA全相合家庭成员（15例）、HLA部分相合亲属（3例）或冷冻保存的自体骨髓（2例）。治疗方案包括15例患者接受环磷酰胺（CY）和全身照射（TBI），13例患者接受白消安（BU）和CY。8例双胞胎中有3例存活，2例在24个月和34个月时无疾病，1例在116个月时存活且状况良好，除有一个小的残留单克隆蛋白峰外无疾病证据。18例接受同种异体移植的患者中有12例死于移植相关原因，2例死于疾病进展。18例同种异体移植受者中有4例存活；2例在16个月和15个月时无疾病，1例在6个月时存活无疾病，除有持续的单克隆κ蛋白外。1例患者在7个月时存活，有残留骨髓受累和持续的IgAλ单克隆蛋白。2例自体移植受者中有1例在移植后2个月存活，尚未评估肿瘤反应，另1例患者早期死于移植相关并发症。CY + TBI和BU + CY均使晚期浆细胞恶性肿瘤患者获得缓解。然而，最佳治疗方案和移植时机仍有待确定。
