Alix School of Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Blood Cancer J. 2023 Aug 18;13(1):126. doi: 10.1038/s41408-023-00900-z.
Allogeneic stem cell transplant (allo SCT) for multiple myeloma (MM) is potentially curative in some, while toxic in many others. We retrospectively analyzed 85 patients diagnosed with MM who underwent allo SCT as frontline or salvage therapy between 2000 and 2022 at Mayo Clinic Rochester and examined patient outcomes and prognostic markers. Overall survival (OS), progression free survival (PFS), treatment related mortality (TRM), and relapse rates (RR) were estimated using the Kaplan Meier method and competing risk models. Median follow-up was 11.5 years. Median OS and PFS were 1.7 and 0.71 years, respectively. Five-year OS and PFS were 22.2% and 15.1%, respectively. One-year TRM was 23.5%. Twelve patients demonstrated durable overall survival, living 10+ years beyond their allo SCT. This subgroup was more likely to have no or one prior auto SCT (p = 0.03) and to have been transplanted between 2000 and 2010 (p = 0.03). Outcomes were poor in this cohort with long follow-up, with few patients surviving 5 years or more, and most relapsing or dying within 2 years. We would expect better outcomes and tolerability with an expanded array of novel therapeutics and would prefer them to allo SCT.
异基因造血干细胞移植（allo SCT）对多发性骨髓瘤（MM）在某些患者中具有潜在的治愈作用，但在许多其他患者中则具有毒性。我们回顾性分析了 2000 年至 2022 年在梅奥诊所罗切斯特分校接受 allo SCT 作为一线或挽救治疗的 85 例 MM 患者，研究了患者的结局和预后标志物。采用 Kaplan-Meier 法和竞争风险模型估计总生存（OS）、无进展生存（PFS）、治疗相关死亡率（TRM）和复发率（RR）。中位随访时间为 11.5 年。中位 OS 和 PFS 分别为 1.7 年和 0.71 年。5 年 OS 和 PFS 分别为 22.2%和 15.1%。1 年 TRM 为 23.5%。12 例患者表现出持久的总体生存，在 allo SCT 后存活 10 年以上。该亚组无或仅有一次自身造血干细胞移植（p=0.03），且移植时间在 2000 年至 2010 年之间（p=0.03）的可能性更大。在这一随访时间较长的队列中，结局较差，只有少数患者存活 5 年或以上，大多数在 2 年内复发或死亡。我们预计新型治疗方法的应用会带来更好的结局和耐受性，并且会优先选择 allo SCT。
