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自体骨髓移植治疗多发性骨髓瘤患者的骨髓造血干细胞。

Autologous Bone Marrow Transplant in Multiple Myeloma Patient With Bone Marrow Hematopoietic Stem Cell.

机构信息

Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University - Kariadi Hospital, Semarang, Indonesia.

出版信息

Acta Med Indones. 2020 Oct;52(4):383-387.

Abstract

Multiple myeloma (MM) is a malignancy with multiple complications such as recurrent bacterial infections, anemia, osteolytic lesions, bone marrow failure and decreased kidney function. In developed transplant center, the bone marrow transplant procedure is performed by the source of peripheral blood stem cells. Apheresis machine which is not always available in all Haematology and Oncology Centre in Indonesia, is required for harvesting stem cell from PBSC (peripheral blood stem cell). There are only a few reports on marrow-derived stem cells transplant from BM with a 24-hour storage in multiple myeloma cases. We report two cases with non-secretory myeloma stage III and IgG myeloma stage II (International Staging System). Both patients were treated with induction regimens CyBord until a complete remission. Once remission was achieved, an autologous bone marrow transplant procedures were performed. The source of haematopietic stem cells (HSCs) were harvested from bone marrow and stored for 24 hours at a temperature of 4◦ C. The complications were neutropenia, anemia, thrombocytopenia, mucositis, diarrhea, hair loss, and skin darkness. The HSCs grew well on day 12 and 23. After treatment in the isolation room, the patient's condition improved and the patients were discharged.

摘要

多发性骨髓瘤(MM)是一种具有多种并发症的恶性肿瘤,如反复细菌感染、贫血、溶骨性病变、骨髓衰竭和肾功能下降。在发达的移植中心,骨髓移植程序是通过外周血干细胞的来源进行的。在印度尼西亚的所有血液科和肿瘤科中心,并不总是能获得用于从 PBSC(外周血干细胞)中采集干细胞的血细胞分离机。在多发性骨髓瘤病例中,只有少数关于骨髓来源的干细胞移植与骨髓保存 24 小时的报告。我们报告了两例非分泌性骨髓瘤 III 期和 IgG 骨髓瘤 II 期(国际分期系统)的病例。两名患者均接受 CyBord 诱导方案治疗,直至完全缓解。一旦缓解,就进行自体骨髓移植。造血干细胞(HSCs)的来源从骨髓中采集,并在 4°C 的温度下储存 24 小时。并发症包括中性粒细胞减少症、贫血、血小板减少症、黏膜炎、腹泻、脱发和皮肤变黑。HSCs 在第 12 天和第 23 天生长良好。在隔离室治疗后,患者病情改善,患者出院。

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