Ning X, Wei X, Guo X, Wei Q, Huang F, Fan Z, Xu N, Sun J, Feng R, Liu Q, Wei Y
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2021 Aug 31;41(9):1420-1425. doi: 10.12122/j.issn.1673-4254.2021.09.19.
To evaluate the effect of autologous stem cell transplantation (ASCT) on treatment response and survival outcomes in patients with newly diagnosed multiple myeloma (MM) receiving treatments with proteasome inhibitors and lenalidomide.
We retrospectively collected the clinical data of newly diagnosed MM patients, who were eligible for ASCT and received proteasome inhibitors or lenalidomide-based treatment in our hospital from January, 2015 to December, 2019. The patients were divided into transplantation group and non-transplantation group, and in transplantation group, the patients received 4 to 6 courses of induction therapy with proteasome inhibitors or lenalidomide before ASCT, while those in the non-transplantation group received more than 8 courses of induction and consolidation therapy with proteasome inhibitors or lenalidomide-based regimens. The therapeutic efficacy and survival outcomes of the patinets were compared between the two groups.
A total of 105 patients were enrolled in the study, including 48 (45.7%) in transplantation group and 57 (54.3%) in non-transplantation group. The two groups were matched for gender, age and treatment response after 4 courses of induction therapy ( > 0.05). The rate of optimal response before relapse differed significantly between the two groups (=0.000), and the patients receiving ASCT had significantly higher rates of complete response (85.4% 54.4%, = 0.001) and very good partial response or better (95.8% 73.7%, =0.002) than those without ASCT. At the end of follow-up, the median progression-free survival in the transplantation group was not reached, as compared with 29 months in the nontransplantation group (=0.013). The median overall survival (OS) in the two groups was not reached, but the OS was better in the transplant group than in the non-transplant group (=0.022).
ASCT can further improve the depth of remission and survival outcomes in patients with newly diagnosed MM receiving treatments with proteasome inhibitors and lenalidomide.
评估自体干细胞移植（ASCT）对接受蛋白酶体抑制剂和来那度胺治疗的新诊断多发性骨髓瘤（MM）患者治疗反应和生存结局的影响。
我们回顾性收集了2015年1月至2019年12月在我院符合ASCT条件并接受蛋白酶体抑制剂或来那度胺为基础治疗的新诊断MM患者的临床资料。患者分为移植组和非移植组，移植组患者在ASCT前接受4至6个疗程的蛋白酶体抑制剂或来那度胺诱导治疗，而非移植组患者接受超过8个疗程的蛋白酶体抑制剂或来那度胺为基础方案的诱导和巩固治疗。比较两组患者的治疗疗效和生存结局。
共纳入105例患者，其中移植组48例（45.7%），非移植组57例（54.3%）。两组在性别、年龄和4个疗程诱导治疗后的治疗反应方面相匹配（>0.05）。两组两组复发治疗反应两组间复发前最佳反应率差异有统计学意义（=0.000），接受ASCT的患者完全缓解率（85.4%对54.4%，=0.001）和非常好的部分缓解或更好反应率（95.8%对73.7%，=0.002）显著高于未接受ASCT的患者。随访结束时，移植组无进展生存期未达到中位数，而非移植组为29个月（=0.013）。两组总生存期（OS）均未达到中位数，但移植组的OS优于非移植组（=0.022）。
ASCT可进一步提高接受蛋白酶体抑制剂和来那度胺治疗的新诊断MM患者的缓解深度和生存结局。
