Tura S, Cavo M, Gobbi M, Rosti G, Bandini G, Miggiano C, Albertazzi L, Grimaldi M, Visani G
Eur J Haematol Suppl. 1989;51:191-5. doi: 10.1111/j.1600-0609.1989.tb01516.x.
17 patients with multiple myeloma (MM) received marrow transplants from their HLA-matched, MLC-negative sibling donors. 9 patients had progressive disease not responding to conventional treatments, while the other 8 patients were rated as responders. The most frequently used conditioning regimen consisted of total body irradiation and high-dose, multi-agent chemotherapy with cyclophosphamide plus either oral melphalan (5 cases) or BCNU (1 case) on both these drugs (7 cases). 12 patients were evaluable for response to BTM: 7 of them (6 responders and 1 with advanced refractory MM) entered complete remission, while 5 had a sustained decrease in tumor mass that ranged between 72% and 93%. 11 patients died of transplant-related causes, 1 of them with signs of progressive disease. The remaining 6 patients are alive and 5 of them maintain a complete remission status 4 to 67 (median 36) months after BMT. It is concluded that therapeutic benefits of transplantation in MM are still offset by the high mortality related to the procedure. A more accurate selection of patients who would most benefit from BMT and performing transplant at an earlier phase of the disease are warranted before major advances can be made in the cure of these patients.
17例多发性骨髓瘤（MM）患者接受了来自与其HLA匹配、混合淋巴细胞培养阴性的同胞供者的骨髓移植。9例患者患有对传统治疗无反应的进展性疾病，而其他8例患者被评定为反应者。最常用的预处理方案包括全身照射以及大剂量多药化疗，化疗药物为环磷酰胺加口服马法兰（5例）或卡莫司汀（1例），或两者并用（7例）。12例患者可评估对骨髓移植（BMT）的反应：其中7例（6例反应者和1例晚期难治性MM患者）进入完全缓解期，而5例患者的肿瘤肿块持续缩小，缩小幅度在72%至93%之间。11例患者死于与移植相关的原因，其中1例有疾病进展的迹象。其余6例患者存活，其中5例在BMT后4至67个月（中位时间36个月）保持完全缓解状态。结论是，MM移植的治疗益处仍被与该手术相关的高死亡率所抵消。在这些患者的治愈方面取得重大进展之前，有必要更准确地选择最能从BMT中获益的患者，并在疾病的早期阶段进行移植。
