Ciftciler Rafiye, Goker Hakan, Buyukasık Yahya, Aladag Elifcan, Demiroglu Haluk
Departments of Hematology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey.
Indian J Hematol Blood Transfus. 2019 Oct;35(4):655-661. doi: 10.1007/s12288-019-01108-7. Epub 2019 Mar 4.
The overall survival (OS) in patients with multiple myeloma (MM) has increased in the last decade due to the introduction of proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies as well as an extensive combination of autologous stem cell transplantation (ASCT) for suitable patients. The objective of this study was to examine the impact of pre-transplant and post-transplant remission status of patients on survival in newly diagnosed multiple myeloma. Two hundred and four patients with newly diagnosed MM who received an ASCT in our HSC transplant center at Hacettepe University Hospital between the years of 2001 and 2018 were evaluated in a retrospective manner. The median follow-up period was 35.9 months (range 4.2-206.4) for the entire group. The 5-year OS for pre-transplant remission status CR/VGPR patients and pre-transplant remission status PR or less patients were 79% and 68%, respectively ( = 0.09). The 5-year PFS for pre-transplant remission status CR/VGPR patients and pre-transplant remission status PR or less patients were 62% and 45%, respectively ( = 0.23). The 5-year OS for post-transplant remission status CR/VGPR group was 72% and for post-transplant remission status PR or less group was 60% ( = 0.02). The 5-year PFS in post-transplant remission status CR/VGPR patients was 48% and post-transplant remission status PR or less patients was 36% ( = 0.03). This study focuses on determination of survival outcome based on the best response obtained before and after ASCT and particularly highlights the significance of reaching CR and VGPR.
在过去十年中,由于蛋白酶体抑制剂、免疫调节药物和单克隆抗体的引入,以及对合适患者广泛采用自体干细胞移植(ASCT)联合治疗,多发性骨髓瘤(MM)患者的总生存期(OS)有所提高。本研究的目的是探讨新诊断的多发性骨髓瘤患者移植前和移植后缓解状态对生存的影响。我们对2001年至2018年间在哈杰泰佩大学医院造血干细胞移植中心接受ASCT的204例新诊断MM患者进行了回顾性评估。整个队列的中位随访时间为35.9个月(范围4.2 - 206.4个月)。移植前缓解状态为完全缓解(CR)/非常好的部分缓解(VGPR)的患者和移植前缓解状态为部分缓解(PR)或更低的患者,其5年总生存率分别为79%和68%(P = 0.09)。移植前缓解状态为CR/VGPR的患者和移植前缓解状态为PR或更低的患者,其5年无进展生存率分别为62%和45%(P = 0.23)。移植后缓解状态为CR/VGPR组的5年总生存率为72%,移植后缓解状态为PR或更低组的为60%(P = 0.02)。移植后缓解状态为CR/VGPR的患者5年无进展生存率为48%,移植后缓解状态为PR或更低的患者为36%(P = 0.03)。本研究着重于根据ASCT前后获得的最佳缓解来确定生存结果,尤其强调达到CR和VGPR的重要性。