Jagannath S, Vesole D H, Tricot G, Crowley J, Salmon S E, Barlogie B
Division of Hematology-Oncology, Arkansas Cancer Research Center, U of Arkansas for Medical Sciences, Little Rock.
Oncology (Williston Park). 1994 Nov;8(11):89-103; discussion 103-6.
Recently, high-dose therapy has been evaluated in patients with multiple myeloma, mainly with autologous transplant support. As a result of rapid hemopoietic engraftment with peripheral blood stem cells collected after chemotherapy and/or hemopoietic growth factor priming, procedure-related mortality has dropped to below 5%. When applied within 12 months from initial therapy, autologous transplants effect complete remissions in up to 50% of patients, with median event-free and overall survival durations on the order of 2.5 and 4 to 5 years, respectively. Complete response rates with allogeneic transplantation range from 30% to 50%, and procedure-related mortality is approximately 40%. Although the median durations of event-free and overall survival are shorter with allogeneic transplants, approximately 35% to 40% of patients survive with minimal disease for at least 5 to 6 years. Direct comparisons of standard therapy and autologous transplants have just begun.
最近，高剂量疗法已在多发性骨髓瘤患者中进行了评估，主要是在自体移植支持下。由于化疗后采集的外周血干细胞和/或造血生长因子预处理后造血迅速植入，与操作相关的死亡率已降至5%以下。在初始治疗后12个月内进行自体移植，高达50%的患者可实现完全缓解，无事件生存期和总生存期的中位数分别约为2.5年和4至5年。异基因移植的完全缓解率为30%至50%，与操作相关的死亡率约为40%。尽管异基因移植的无事件生存期和总生存期的中位数较短，但约35%至40%的患者可在疾病最小化的情况下存活至少5至6年。标准疗法与自体移植的直接比较才刚刚开始。
