Alexanian R, Dimopoulos M, Smith T, Delasalle K, Barlogie B, Champlin R
University of Texas M.D. Anderson Cancer Center, Houston 77030.
Blood. 1994 Jan 15;83(2):512-6.
The utility of myeloablative therapy supported by autologous bone marrow (BM) or blood progenitor cells was assessed in 49 patients with multiple myeloma who had received at least 1 year of prior chemotherapy. Outcomes were compared with those of similar patients who did not receive intensive treatment primarily for socioeconomic reasons. Among patients with disease in resistant relapse despite treatment with vincristine-doxorubicin by continuous infusion with pulse dexamethasone (VAD), a 61% response rate was associated with a median remission time of 5 months. After primary resistance for more than 1 year, 6 of 15 patients responded and the overall survival was similar to that of control patients. For patients with melphalan-resistant disease that responded to VAD, the remission time was similar to that of control patients. Current myeloablative treatments supported by autologous BM or blood stem cells were useful to very few patients with multiple myeloma after the first year of chemotherapy.
对49例接受过至少1年前期化疗的多发性骨髓瘤患者评估了自体骨髓（BM）或血液祖细胞支持的清髓性疗法的效用。将结果与主要因社会经济原因未接受强化治疗的类似患者的结果进行比较。在尽管接受了长春新碱-阿霉素持续输注联合脉冲地塞米松（VAD）治疗仍处于耐药复发状态的患者中，缓解率为61%，中位缓解时间为5个月。在原发耐药超过1年后，15例患者中有6例有反应，总生存期与对照患者相似。对于对VAD有反应的美法仑耐药疾病患者，缓解时间与对照患者相似。在化疗的第一年之后，目前由自体BM或血液干细胞支持的清髓性治疗对极少数多发性骨髓瘤患者有用。
