Firsova M V, Mendeleeva L P, Parovichnikova E N, Solovev M V, Kuzmina L A, Risinskaya N V, Abramova T V, Galtseva I V, Savchenko V G
National Research Center for Hematology.
Ter Arkh. 2021 Jul 23;93(7):778-784. doi: 10.26442/00403660.2021.07.200929.
To analyze the effectiveness of allogeneic hematopoietic stem cell transplantation (allo-HSCT) from a related HLA-identical donor in patients with multiple myeloma (MM).
From 2013 to 2018, the study included 8 patients (6 men, 2 women) aged from 27 to 55 years (median 39 years) with MM who underwent allo-HSCT from a related HLA-identical donor (7 patients after auto-HSCT, in 1 case without previous auto-transplantation). All patients required 2 or more lines of induction therapy, while the achieved antitumor effect was unstable. Before allo-HSCT, complete and very good partial remission was determined in isolated cases, in 4 patients the response was regarded as partial remission, stabilization in 1 observation, progression in 1 patient. All patients underwent reduced intensity conditioning (fludarabine 30 mg/m2 6 days + busulfan 4 mg/kg 2 days). Immunosuppressive therapy included the administration of antithymocyte globulin and post-transplant cyclophosphamide.
Severe acute GVHD (grade 34) was observed in 3 (37.5%) cases, which resulted in death in 1 case. A stable antitumor response was achieved in 5 (62.5%) patients, complete remission lasts for 2986 months after allo-HSCT. Specific therapy for these patients is not carried out. The 7-year progression-free survival rate was 75%, the 7-year overall survival rate was 84%, with a median follow-up of 65 months. The transplant-related mortality was 12.5%.
Allo-HSCT is considered as an alternative method of therapy for young patients with aggressive MM. Allo-HSCT in MM in some cases leads to long-term immunological control of the tumor.
分析来自人类白细胞抗原（HLA）全相合相关供者的异基因造血干细胞移植（allo-HSCT）治疗多发性骨髓瘤（MM）患者的疗效。
2013年至2018年，该研究纳入了8例年龄在27至55岁（中位年龄39岁）的MM患者（6例男性，2例女性），他们接受了来自HLA全相合相关供者的allo-HSCT（7例患者在自体造血干细胞移植[auto-HSCT]后进行，1例患者未进行过自体移植）。所有患者均需要2线或更多线的诱导治疗，且获得的抗肿瘤效果不稳定。allo-HSCT前，个别病例达到完全缓解和非常好的部分缓解，4例患者的反应为部分缓解，1例观察病例病情稳定，1例患者病情进展。所有患者均接受了减低强度预处理（氟达拉滨30mg/m²，共6天+白消安4mg/kg，共2天）。免疫抑制治疗包括给予抗胸腺细胞球蛋白和移植后环磷酰胺。
3例（37.5%）患者发生严重急性移植物抗宿主病（GVHD，3-4级），其中1例导致死亡。5例（62.5%）患者获得了稳定的抗肿瘤反应，allo-HSCT后完全缓解持续29-86个月。未对这些患者进行特殊治疗。7年无进展生存率为75%，7年总生存率为84%，中位随访时间为65个月。移植相关死亡率为12.5%。
allo-HSCT被认为是年轻的侵袭性MM患者的一种替代治疗方法。MM患者进行allo-HSCT在某些情况下可导致对肿瘤的长期免疫控制。
