新药硼替佐米条件下的自体造血干细胞移植治疗多发性骨髓瘤

Autologous hematopoietic stem cell transplantation for multiple myeloma in patients on bortezomib therapy

  • 摘要: 目的 了解新药硼替佐米(Bor)治疗条件下自体造血干细胞移植(AHCT)治疗多发性骨髓瘤(MM)的安全性及疗效。 方法 回顾性分析我科2008年3月-2010年4月18例符合条件MM患者进行AHCT的安全性与疗效。 结果 18例AHCT预处理方案:大剂量马法兰(HDM)8例,Bor联合HDM(Bor-HDM)10例。8例诱导治疗和移植预处理方案均应用Bor治疗,8例诱导治疗时应用Bor而移植预处理方案未应用,2例诱导治疗未应用而移植预处理应用Bor。HDM和Bor-HDM组移植中恶心、呕吐、厌食、腹泻、口腔黏膜炎及发热均无统计学差异(P>0.1)。移植后粒系重建中位时间HDM组12d,Bor-HDM组13d(P>0.1);血小板重建中位时间HDM组16.5d,Bor-HDM组18d(P>0.1)。移植后14例接受反应停维持治疗。随访25(14-39)月,11例出现疾病进展,进展时间6-25月;HDM组进展4例,Bor-HDM进展6例(P>0.1)。AHCT后2年无疾病进展生存率为(44.2±12)%。 结论 新药硼替佐米治疗条件下MM进行AHCT安全、易行,但移植后仍易出现疾病进展。

     

    Abstract: Objective To observe the safety and efficacy of autologous hematopoietic stem cell transplantation(AHCT) for multiple myeloma(MM) in patients receiving bortezomib(Bor). Methods Safety and efficacy of AHCT for MM in 18 patients receiving Bor admitted to our department from March 2008 to April 2010 were retrospectively analyzed. Results Of the 18 MM patients,8 were treated with a high dose of melphalan(HDM),10 were treated with combined Bor and HDM(Bor-HDM),8 received Bor during induction therapy and AHCT,2 did not receive Bor during induction therapy but received Bor during AHCT.No significant difference was observed in nausea,vomiting,diarrhea,oral mucositis,and fever between HDM group and Bor-HDM group(P>0.1).The median time for reconstruction of granulocytes was 12d and 13d,respectively,while the median time for reconstruction of platelets was 16.5d and 18d,respectively,in HDM group and Bor-HDM group after AHCT(P>0.1).Fourteen patients received maintenance treatment with thalidomide.The patients were followed up for 25(14-39)d,during which the disease was progressed in 11 patients(4 in HDM group and 6 in Bor-HDM group) from 6 months to 25 months after AHCT.The disease-free survival rate was 44.2%±12% the MM patients 2 years after AHCT. Conclusion AHCT is a safe and easy procedure for MM in patients receiving Bor,but MM is easy to progress after it.

     

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