Zhang Bing-Lei, Zhou Jian, Zhang Gong-Li, Gui Rui-Rui, Lin Quan-De, Zu Ying-Ling, Yu Feng-Kuan Com, Zhao Hui-Fang, Li Zhen, Wang Juan, Fu Yue-Wen, Zhang Li-Na, Zhou Hu, Fang Bai-Jun, Song Yong-Ping
Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China.
Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018 Oct;26(5):1414-1419. doi: 10.7534/j.issn.1009-2137.2018.05.026.
To analyze the clinical efficacy and possible influencing factors of autologous hematopoietic Stem cell transplantation (auto-HSCT) in the treatment of patients with multiple myeloma (MM).
Clinical data of 40 MM patients received auto-HSCT in the Department of Hematology of Henan Cancer Hospital from September 2010 to November 2017 were retrospectively analyzed, the clinical curative efficiency was summarized and the related factors were analyzed.
The curative efficiency of the patients before transplantation was 9(22.5%) with complete remission(CR), 5(12.5%) with very good partial remission(VGPR), 26(65%) with partial remission(PR), respectively, one of them was PR after 3 recurrences. The curative efficiency after transplantation was 22(55%) with complete remission(CR), 12(30%) with very good partial remission(VGPR), 6(15%) with partial remission(PR), respectively. And 2 cases were CR after double transplantation. Median follow-up time was 28.4 (3.1 to 88) months,15 cases presented disease progression, 7 cases were dead, 3-year estimated progression-free survival(PFS) and overall survival(OS) rate were 45.1% and 82% respectively. Unvariate analysis showed that the OS was affected by ISS stage (P<0.05), CR and VGPR (P<0.05) after transplantation; PFS was affected by ISS stage (P<0.01), before transplantation induction therapy (27 cases with bortezomizomi or thalidomide) (P<0.05), disease risk stratification (6 cases in high risk group) (P<0.05) , CR and VGPR (P<0.05) before transplantation, CR and VGPR (P<0.01) after transplantation. Cox multivariate regression analysis showed that the independent prognostic factors for OS were ISS stage, CR and VGPR after transplantation; the independent prognostic factors for PFS were the CR, VGPR, ISS stage after transplantation and induction therapy before transplant.
Auto-HSCT can improve the clinical efficacy and survival rate of MM patients; ISS stage, CR and VGPR after transplantation are independent prognostic factors for OS and PFS, and induction therapy before transplantation is also an independent prognostic factor for PFS.
分析自体造血干细胞移植（auto-HSCT）治疗多发性骨髓瘤（MM）患者的临床疗效及可能的影响因素。
回顾性分析2010年9月至2017年11月在河南省肿瘤医院血液科接受auto-HSCT的40例MM患者的临床资料，总结临床疗效并分析相关因素。
移植前患者疗效分别为完全缓解（CR）9例（22.5%）、很好的部分缓解（VGPR）5例（12.5%）、部分缓解（PR）26例（65%），其中1例3次复发后为PR。移植后疗效分别为CR 22例（55%）、VGPR 12例（30%）、PR 6例（15%）。2例经两次移植后为CR。中位随访时间为28.4（3.1至88）个月，15例出现疾病进展，7例死亡，3年无进展生存（PFS）率和总生存（OS）率分别为45.1%和82%。单因素分析显示，OS受国际分期系统（ISS）分期（P<0.05）、移植后CR和VGPR（P<0.05）影响；PFS受ISS分期（P<0.01）、移植前诱导治疗（27例使用硼替佐米或沙利度胺）（P<0.05）、疾病风险分层（6例高危组）（P<0.05）、移植前CR和VGPR（P<0.05）、移植后CR和VGPR（P<0.01）影响。Cox多因素回归分析显示，OS的独立预后因素为ISS分期、移植后CR和VGPR；PFS的独立预后因素为移植后CR、VGPR、ISS分期及移植前诱导治疗。
auto-HSCT可提高MM患者的临床疗效和生存率；ISS分期、移植后CR和VGPR是OS和PFS的独立预后因素，移植前诱导治疗也是PFS的独立预后因素。
