Fares Salma, Hadri Halima, Rachid Mohamed, Moutiqui Tarik, Oukkache Bouchra, Quessar Asmaa
Service d´Hématologie et d´Oncologie Pédiatrique, Hôpital 20 Août 1953, CHU Ibn Rochd, Casablanca, Maroc.
Service d´Hémato-biologie, CHU Ibn Rochd, Casablanca, Maroc.
Pan Afr Med J. 2021 Jun 4;39:105. doi: 10.11604/pamj.2021.39.105.18994. eCollection 2021.
High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) is the gold standard treatment for multiple myeloma in subjects aged ≤ 65 years. In developing countries, AHSCT without cryopreservation reduces the costs of hospitalization and all necessary equipments. We conducted a longitudinal, prospective, open study to evaluate this procedure at the Department of Clinical Hematology, Casablanca, Morocco. Data from the medical records of 64 patients were collected over a period of 24 months. After induction therapy, the overall response (complete remission + very good partial response) was 67.2% (43 patients). The mean CD34-cell count in the autograft was 12.9710 /kg [2.4- 5310 Cd34+/kg] and the median length of hospitalization was 20.5 days [14-60 days]. The overall response after autograf was 84% (54 patients). At 24 months follow-up, overall survival (OS) was 83.5%, median OS was not reached and progression-free survival (PFS) was 65.9%, with a median PFS of 24.1 months with 95% confidence interval [21.7-26.5 months]. Autologous hematopoietic stem cell transplantation without cryopreservation is an excellent alternative in our context reducing wait times and freezing costs.
大剂量化疗后行自体造血干细胞移植（AHSCT）是65岁及以下多发性骨髓瘤患者的金标准治疗方法。在发展中国家，不进行冷冻保存的AHSCT可降低住院费用及所有必要设备的成本。我们在摩洛哥卡萨布兰卡临床血液科进行了一项纵向、前瞻性、开放性研究，以评估该程序。在24个月的时间里收集了64例患者的病历数据。诱导治疗后，总缓解率（完全缓解+非常好的部分缓解）为67.2%（43例患者）。自体移植物中平均CD34细胞计数为12.97×10⁶/kg [2.4 - 53×10⁶ CD34⁺/kg]，中位住院时间为20.5天[14 - 60天]。自体移植后的总缓解率为84%（54例患者）。在24个月的随访中，总生存率（OS）为83.5%，未达到中位OS，无进展生存率（PFS）为65.9%，中位PFS为24.1个月，95%置信区间为[21.7 - 26.5个月]。在我们的情况下，不进行冷冻保存的自体造血干细胞移植是一种很好的选择，可减少等待时间和冷冻成本。
