Paviglianiti Annalisa, Xavier Erick, Ruggeri Annalisa, Ceballos Patrice, Deconinck Eric, Cornelissen Jan J, Nguyen-Quoc Stephanie, Maillard Natacha, Sanz Guillermo, Rohrlich Pierre-Simon, Garderet Laurent, Volt Fernanda, Rocha Vanderson, Kroeger Nicolaus, Gluckman Eliane, Fegueux Nathalie, Mohty Mohamad
Eurocord, APHP, University Paris Diderot, Hôpital Saint Louis, Paris, France Monacord, Centre Scientifique de Monaco, France
Eurocord, APHP, University Paris Diderot, Hôpital Saint Louis, Paris, France Monacord, Centre Scientifique de Monaco, France.
Haematologica. 2016 Sep;101(9):1120-7. doi: 10.3324/haematol.2015.138917. Epub 2016 May 26.
Although allogeneic stem cell transplantation is not a standard therapy for multiple myeloma, some patients can benefit from this intense therapy. There are few reports on outcomes after umbilical cord blood transplantation in multiple myeloma, and investigation of this procedure is warranted. We retrospectively analyzed 95 patients, 85 with multiple myeloma and 10 with plasma cell leukemia, receiving single or double umbilical cord blood transplantation from 2001 to 2013. Median follow up was 41 months. The majority of patients received a reduced intensity conditioning. The cumulative incidence of neutrophil engraftment was 97%±3% at 60 days, and that of 100-day acute graft-versus-host disease grade II-IV was 41%±5%. Chronic graft-versus-host disease at two years was 22%±4%. Relapse and non-relapse mortality was 47%±5% and 29%±5% at three years, respectively. Three-year progression-free survival and overall survival were 24%±5% and 40%±5%, respectively. Anti-thymocyte globulin was associated with decreased incidence of acute graft-versus-host disease, higher non-relapse mortality, decreased overall and progression-free survival. Patients with high cytogenetic risk had higher relapse, and worse overall and progression-free survival. In conclusion, umbilical cord blood transplantation is feasible for multiple myeloma patients.
尽管异基因干细胞移植并非多发性骨髓瘤的标准治疗方法，但一些患者可从这种强化治疗中获益。关于多发性骨髓瘤患者接受脐带血移植后的预后报道较少，因此有必要对该治疗方法进行研究。我们回顾性分析了2001年至2013年间接受单份或双份脐带血移植的95例患者，其中85例为多发性骨髓瘤患者，10例为浆细胞白血病患者。中位随访时间为41个月。大多数患者接受了减低强度预处理。中性粒细胞植入的累积发生率在60天时为97%±3%，100天时II-IV级急性移植物抗宿主病的累积发生率为41%±5%。两年时慢性移植物抗宿主病的发生率为22%±4%。三年时复发和非复发死亡率分别为47%±5%和29%±5%。三年无进展生存率和总生存率分别为24%±5%和40%±5%。抗胸腺细胞球蛋白与急性移植物抗宿主病发生率降低、非复发死亡率升高、总生存率和无进展生存率降低相关。细胞遗传学高危患者的复发率更高，总生存率和无进展生存率更差。总之，脐带血移植对多发性骨髓瘤患者是可行的。
