低动员能力骨髓瘤患者预后不良。

Inferior prognosis in poor mobilizing myeloma patients.

机构信息

Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

出版信息

Transfus Apher Sci. 2020 Jun;59(3):102722. doi: 10.1016/j.transci.2020.102722. Epub 2020 Jan 9.

DOI:10.1016/j.transci.2020.102722

PMID:32014363

Abstract

INTRODUCTION

Induction treatment followed by autologous stem cell transplantation (ASCT) has been accepted as the standard treatment for multiple myeloma (MM) patients. Granulocyte colony stimulating agent (G-CSF), chemotherapy or agents likes plerixafor are being used for the mobilization of stem cells from bone marrow. In this study, we evaluated the impact of the mobilization methods on the outcome of MM patients after ASCT.

METHOD

The data of 205 MM patients who underwent ASCT at our center between December 2009 and January 2019 were retrospectively analyzed. Patients were divided into 2 groups as good mobilizers (patients who were mobilized with G-CSF alone) and poor mobilizers (patients who were failed to mobilize with G-CSF alone and mobilized with G-CSF + cylophosphomide or G-CSF + plerixafor).

RESULTS

The median progression free survival (PFS) was 18.27 ± 3.22 months in good mobilizers and 14.22 ± 3.7 months in poor mobilizers. In G-CSF + cyclophosphamide method median PFS was 15.4 ± 4.9 months wheras it was only 4 months in G-CSF + plerixafor method. We did not find a statistically significant difference between good and poor mobilizers regarding median PFS (p: 0.342). The median overall survival (OS) was found 34.48 ± 4.2 months in good mobilizers and 15.13 ± 5.78 months in poor mobilizers. In G-CSF + cyclophosphamide method median OS was 17 ± 14.01 months wheras it was 10.66 ± 7.68 months in G-CSF + plerixafor method. We found a statistically significant difference between good and poor mobilizers regarding median OS (p: 0.007*).

CONCLUSION

Our study shows that difficulty in stem cell mobilization is correlated with worse outcome.

摘要

简介

自体干细胞移植（ASCT）后的诱导治疗已被接受为多发性骨髓瘤（MM）患者的标准治疗。粒细胞集落刺激因子（G-CSF）、化疗或类似plerixafor 的药物被用于从骨髓中动员干细胞。在这项研究中，我们评估了动员方法对 ASCT 后 MM 患者结局的影响。

方法

回顾性分析 2009 年 12 月至 2019 年 1 月在我院行 ASCT 的 205 例 MM 患者的数据。患者分为两组：良好动员者（单用 G-CSF 动员者）和动员不良者（单用 G-CSF 动员失败者，用 G-CSF+环磷酰胺或 G-CSF+plerixafor 动员者）。

结果

良好动员者的无进展生存期（PFS）中位数为 18.27±3.22 个月，动员不良者的 PFS 中位数为 14.22±3.7 个月。在 G-CSF+环磷酰胺组，中位 PFS 为 15.4±4.9 个月，而 G-CSF+plerixafor 组仅为 4 个月。在 PFS 方面，良好动员者与动员不良者的中位 PFS 无统计学差异（p：0.342）。良好动员者的总生存期（OS）中位数为 34.48±4.2 个月，动员不良者的 OS 中位数为 15.13±5.78 个月。在 G-CSF+环磷酰胺组，中位 OS 为 17±14.01 个月，而 G-CSF+plerixafor 组为 10.66±7.68 个月。在 OS 方面，良好动员者与动员不良者的中位 OS 有统计学差异（p：0.007*）。