Department of Hematology, The First People's Hospital of Chenzhou, Chenzhou, People's Republic of China.
Hematology. 2023 Dec;28(1):2255800. doi: 10.1080/16078454.2023.2255800. Epub 2023 Sep 21.
Autologous hematopoietic stem cell transplantation (ASCT) is a crucial method used in patients with multiple myeloma (MM). This study aims to evaluate the role of ASCT in immunoglobulin (Ig) reconstitution and long-term outcomes in patients aged ≥ 60 years.
From March 2008 to May 2019, 93 patients aged ≥ 60 years who were diagnosed with MM and underwent ASCT were retrospectively analyzed. All patients underwent follow-ups and the deadline for follow-up was October 31, 2022. The Ig levels were measured using the immune turbidimetry method at 3, 6, and 12 months after transplantation. Patients who died or experienced relapse were excluded from the analysis. The prognostic value of Ig levels was estimated using the Kaplan-Meier survival curve and Cox regression method.
No patients died, and all patients with complications showed improvements after treatment. Patients in the Ig reconstitution group had a lower international staging system (ISS) stage, whereas those in the immunoparesis group had a higher ISS stage. The median duration of follow-up was 36 (range, 13-120) months. The Ig reconstitution within 12 months indicated a longer overall survival and progression-free survival outcomes. The detection of Ig levels was an independent indicator for the prognosis of MM.
The Ig reconstitution within 12 months of ASCT could predict the overall outcomes of patients with MM aged ≥ 60 years.
自体造血干细胞移植（ASCT）是多发性骨髓瘤（MM）患者的重要治疗方法。本研究旨在评估 ASCT 在≥60 岁 MM 患者免疫球蛋白（Ig）重建和长期预后中的作用。
回顾性分析 2008 年 3 月至 2019 年 5 月接受 ASCT 的 93 例≥60 岁 MM 患者的临床资料。所有患者均接受随访，随访截止日期为 2022 年 10 月 31 日。采用免疫比浊法于移植后 3、6 和 12 个月检测 Ig 水平。排除死亡或复发的患者。采用 Kaplan-Meier 生存曲线和 Cox 回归方法评估 Ig 水平的预后价值。
无患者死亡，所有有并发症的患者经治疗后均有好转。Ig 重建组患者的国际分期系统（ISS）分期较低，而免疫缺陷组患者的 ISS 分期较高。中位随访时间为 36（范围：13-120）个月。12 个月内 Ig 重建提示总生存和无进展生存结局较长。Ig 水平的检测是 MM 预后的独立指标。
ASCT 后 12 个月内 Ig 重建可预测≥60 岁 MM 患者的总体预后。
