Wang Ya-Nan, Zhang Chao-Wei, Gao Yu-Xuan, Ge Xue-Ling
Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China.
The Fifth People's Hospital of Jinan Affiliated to Shandong Second Medical University, Jinan, Shandong, P.R. China.
Technol Cancer Res Treat. 2025 Jan-Dec;24:15330338251321349. doi: 10.1177/15330338251321349. Epub 2025 Mar 25.
Multiple myeloma (MM) is a malignant hematological disease originating from plasma cells that remains incurable. Autologous stem cell transplantation (ASCT) is an important treatment method for MM. With the development of new drugs, the treatment of MM patients who meet the ASCT criteria has significantly improved, and the median survival time has increased by 8-10 years. The current treatment for MM patients who meet the ASCT criteria consists mainly of the following stages: induction therapy, stem cell collection, stem cell transplantation, and consolidation and maintenance therapy. Even today, long-term disease control remains the goal of MM treatment in clinical practice. In the era of new drugs, early ASCT still results in longer progression-free survival (PFS) and is currently the standard treatment method for young newly diagnosed multiple myeloma (NDMM) patients. Moreover, tandem transplantation can be considered for MM patients with high-risk cytogenetics. This review discusses mainly the role of ASCT in MM, the conditions for patient transplantation, the induction chemotherapy regimen before transplantation, the conditioning regimen, the timing of transplantation, and the effectiveness of tandem transplantation, including maintenance and salvage ASCT after transplantation.
多发性骨髓瘤(MM)是一种起源于浆细胞的恶性血液系统疾病,目前仍无法治愈。自体干细胞移植(ASCT)是MM的一种重要治疗方法。随着新药的研发,符合ASCT标准的MM患者的治疗效果有了显著改善,中位生存时间延长了8至10年。目前,符合ASCT标准的MM患者的治疗主要包括以下阶段:诱导治疗、干细胞采集、干细胞移植以及巩固和维持治疗。即便在今天,实现长期疾病控制仍是MM临床治疗的目标。在新药时代,早期进行ASCT仍可带来更长的无进展生存期(PFS),目前这是年轻的新诊断多发性骨髓瘤(NDMM)患者的标准治疗方法。此外,对于具有高危细胞遗传学特征的MM患者,可考虑进行串联移植。本综述主要讨论了ASCT在MM中的作用、患者移植的条件、移植前的诱导化疗方案、预处理方案、移植时机以及串联移植的有效性,包括移植后的维持和挽救性ASCT。