Geng C Y, Yang G Z, Wang G R, Wang H J, Zhou H X, Zhang Z Y, Jian Y, Chen W M
Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Zhonghua Xue Ye Xue Za Zhi. 2021 May 14;42(5):390-395. doi: 10.3760/cma.j.issn.0253-2727.2021.05.007.
To evaluate the effect of autologous stem cell transplantation (auto-HSCT) on treatment remission and survival of newly diagnosed multiple myeloma (MM) patients. A total of 243 new diagnosed MM patients (age ≤65 years) who had received auto-HSCT were selected, and 176 MM patients (age ≤65 years) who had not received auto-HSCT were selected as the control group to evaluate the effect of auto-HSCT on the remission and survival. To balance the distribution of prognostic factors between auto-HSCT and non-auto-HSCT patients, the propensity score matching technique was used to reduce the bias between groups in a 1∶1 scale, 64 in each group, and correlation analysis was performed. A total of 128 patients (64 cases in each group) were screened by propensity score matching analysis. 64 patients received auto-HSCT after induction therapy. After auto-HSCT, 24 patients (37.5%) obtained sCR, 16 patients (25.0%) obtained CR, 15 patients (23.4%) obtained VGPR, and 9 patients (14.1%) obtained PR. The efficacy of patients with auto-HSCT was significantly better than that of non-auto-HSCT patients (=0.032) . Progression-free survival (PFS) and overall survival (OS) were significantly longer in auto-HSCT patients compared with non-auto-HSCT patients[PFS: 42.2 (95% 29.9-54.5) months 22.4 (95% 17.1-27.7) months, =0.007; OS: 87.6 (95% 57.3-117.9) months 53.9 (95% 36.1-71.7) months, =0.011]. Multivariate analysis confirmed that auto-HSCT had a favorable effect on OS (=0.448, 95% 0.260-0.771, =0.004) and PFS (=0.446, 95% 0.280-0.778, =0.003) . These results demonstrated that auto-HSCT was a favorable prognostic factor for newly diagnosed MM patients.
评估自体干细胞移植（auto-HSCT）对新诊断的多发性骨髓瘤（MM）患者治疗缓解及生存的影响。共选取243例接受auto-HSCT的新诊断MM患者（年龄≤65岁），并选取176例未接受auto-HSCT的MM患者（年龄≤65岁）作为对照组，以评估auto-HSCT对缓解及生存的影响。为平衡auto-HSCT组和非auto-HSCT组患者预后因素的分布，采用倾向评分匹配技术按1∶1比例减少组间偏倚，每组64例，并进行相关性分析。通过倾向评分匹配分析共筛选出128例患者（每组64例）。64例患者在诱导治疗后接受auto-HSCT。auto-HSCT后，24例患者（37.5%）获得严格完全缓解（sCR），16例患者（25.0%）获得完全缓解（CR），15例患者（23.4%）获得非常好的部分缓解（VGPR），9例患者（14.1%）获得部分缓解（PR）。auto-HSCT患者的疗效显著优于非auto-HSCT患者（=0.032）。auto-HSCT患者的无进展生存期（PFS）和总生存期（OS）显著长于非auto-HSCT患者[PFS：42.2（95% 29.9 - 54.5）个月对22.4（95% 17.1 - 27.7）个月，=0.007；OS：87.6（95% 57.3 - 117.9）个月对53.9（95% 36.1 - 71.7）个月，=0.011]。多因素分析证实auto-HSCT对OS（=0.448，95% 0.260 - 0.771，=0.004）和PFS（=0.446，95% 0.280 - 0.778，=0.003）有有利影响。这些结果表明auto-HSCT是新诊断MM患者的一个有利预后因素。
