Alexanian R, Dimopoulos M A, Delasalle K B, Hester J, Champlin R
University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Stem Cells. 1995 Aug;13 Suppl 2:118-21. doi: 10.1002/stem.5530130718.
Myeloablative therapy supported by autologous bone marrow or blood stem cell transplantation was assessed in 41 patients who had multiple myeloma resistant to vincristine-doxorubicin by continuous infusion with high-dose dexamethasone (VAD) or other high-dose dexamethasone regimens. In patients who had high or intermediate tumor mass, the myeloma cell mass was reduced by more than 75% in 56% of patients and the survival time quadrupled in comparison with that of a matched control group. Later treatment resulted in a lower response rate and shorter remission. Current myeloablative regimens supported by autologous stem cells provided a useful treatment for patients who had advanced primary resistant multiple myeloma. Such treatment should be given early in the disease course to provide the best chance for remission, collecting blood stem cells with facility, and preventing complications that would increase the risk of the procedure.
对41例对长春新碱-阿霉素持续静脉输注高剂量地塞米松（VAD）或其他高剂量地塞米松方案耐药的多发性骨髓瘤患者，评估了自体骨髓或血干细胞移植支持下的清髓性治疗。在肿瘤负荷高或中等的患者中，56%的患者骨髓瘤细胞量减少超过75%，与匹配的对照组相比，生存时间延长了四倍。后续治疗的缓解率较低且缓解期较短。目前自体干细胞支持下的清髓性方案为晚期原发性耐药多发性骨髓瘤患者提供了一种有效的治疗方法。这种治疗应在病程早期进行，以提供最佳的缓解机会、方便地采集血干细胞，并预防会增加手术风险的并发症。
