Kang Jihoon, Hong Jung Yong, Yoon Dok Hyun, Kim Shin, Lee Kyoung Min, Park Jung Sun, Park Chan-Jeoung, Min Won-Ki, Seo Eul-Ju, Jang Seongsoo, Suh Cheolwon
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Acta Haematol. 2018;139(3):185-192. doi: 10.1159/000486664. Epub 2018 Apr 10.
Immunoglobulin D multiple myeloma (IgD MM) is characterized by a poor prognosis. Data are lacking on the survival benefits associated with the use of novel agents followed by autologous stem cell transplantation (ASCT) in IgD MM patients. We evaluated the clinical outcomes of induction treatment with novel agents followed by ASCT.
This was a single-center, retrospective study of 22 IgD MM patients who underwent ASCT between 1995 and 2016. Of these, 10 (45.4%) received novel agents and 12 (54.6%) received nonnovel agents. Clinical features and survival outcomes were examined.
Median overall survival (OS) was 37.7 months in the 22 patients. Those in the novel-agents group received bortezomib or thalidomide-based regimens, whereas 91.7% of the nonnovel-agents group received a vincristine-based regimen. The median progression-free survival and OS in the novel-agent/nonnovel-agent groups were 8.3/7.4 and 38.6/12.5 months, respectively. The median OS of patients receiving maintenance therapy was not reached.
This study showed improved survival outcomes compared to our previous study (37.7 vs. 12 months), suggesting that the use of a novel agent as induction and maintenance therapy may be beneficial in patients with IgD MM who undergo ASCT.
免疫球蛋白D型多发性骨髓瘤（IgD MM）预后较差。目前缺乏关于IgD MM患者使用新型药物后进行自体干细胞移植（ASCT）的生存获益数据。我们评估了使用新型药物诱导治疗后进行ASCT的临床结局。
这是一项对1995年至2016年间接受ASCT的22例IgD MM患者进行的单中心回顾性研究。其中，10例（45.4%）接受了新型药物治疗，12例（54.6%）接受了非新型药物治疗。对临床特征和生存结局进行了检查。
22例患者的中位总生存期（OS）为37.7个月。新型药物组患者接受了基于硼替佐米或沙利度胺的方案，而非新型药物组91.7%的患者接受了基于长春新碱的方案。新型药物组/非新型药物组的中位无进展生存期和OS分别为8.3/7.4个月和38.6/12.5个月。接受维持治疗患者的中位OS未达到。
本研究显示与我们之前的研究相比生存结局有所改善（37.7个月对12个月），表明使用新型药物作为诱导和维持治疗可能对接受ASCT的IgD MM患者有益。
