白消安联合环磷酰胺的预处理方案在多发性骨髓瘤自体干细胞移植中的应用  

Application of Conditioning Regimen with Busulfan and Cyclophosphamide in Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma

作　　者：徐云[1] 周进[1] 马玲[1] 金松[1] 颜灵芝[1] 商京晶[1] 吴德沛[1] 傅琤琤[1] XU Yun;ZHOU Jin;MA Ling;JIN Song;YAN Ling-Zhi;SHANG Jing-Jing;WU De-Pei;FU Cheng-Cheng(Department of Hematology,The First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,Suzhou 215000,Jiangsu Province,China)

机构地区：[1]苏州大学附属第一医院血液内科,江苏省血液研究所,江苏苏州215000

出　　处：《中国实验血液学杂志》2021年第6期1831-1836,共6页Journal of Experimental Hematology

摘　　要：目的:评价BUCY(白消安+环磷酰胺)预处理方案应用于多发性骨髓瘤患者自体造血干细胞移植的安全性和疗效性。方法:回顾性分析2012年5月至2015年6月苏州大学附属第一人民医院血液内科72例多发性骨髓瘤移植患者的临床资料,其中36例患者接受BUCY预处理方案,36例接受HDM预处理方案,比较两组移植期间并发症、移植后造血重建和疗效。结果:两组患者基本资料,包括性别、年龄、分型分期、诱导方案、动员方案及预处理方案加用硼替佐米的比例差异均无统计学意义。BUCY组和HDM组中性粒细胞植入时间分别为10(8-17)和10(9-13)d(P=0.046),血小板植入时间分别为10(8-18)和11(9-47)d(P=0.017)。BUCY组和HDM组的移植相关死亡率均为2.7%。BUCY组和HDM组ASCT后的CR率(38.9%和50.0%)均高于ASCT前(27.8%和19.4%)。BUCY组中位随访45(0-61)个月,有15例(41.7%)患者出现疾病进展。HDM组中位随访52(0-75)个月,有22例(61.1%)患者出现疾病进展。结论:BUCY方案对于患者是安全有效的自体造血干细胞移植预处理方案。在安全性和疗效性上,BUCY方案不劣于HDM方案。BUCY方案或可取代HDM方案作为多发性骨髓瘤自体造血干细胞移植的标准预处理方案。Objective: To evaluate the safety and efficacy of BUCY(busulfan and cyclophosphamide) conditioning regimen for autologous hematopoietic stem cell transplantation(ASCT) in patients with multiple myeloma(MM).Methods: The clinical data of 72 MM patients received transplantation in the Hematology Department of the First Affiliated Hospital of Soochow University from May 2012 to June 2015 were retrospectively analyzed. Among them,36 patients received BUCY conditioning regimen while the others received high-dose melphalan(HDM) conditioning regimen. The complication, post-transplantation hematopoietic reconstitution and efficacy between the two groups were compared. Results: There were no significant differences in sex, age, isotype, stage, induction therapy, mobilization method and proportion of conditioning regimen with Bortezomib between the two groups. The median time of neutrophil engraftment for the patients in BUCY and HDM groups was 10(8-17) and 10(9-13) d(P=0.046), and the median time of platelet engraftment was 10(8-18) and 11(9-47) d(P=0.017), respectively. The transplant related mortality of the patients in both groups was 2.7%. The CR rates of the patients after ASCT(38.9% and 50.0%) were higher than those before ASCT(27.8% and 19.4%) in the two groups. For the patients in BUCY group, the median follow-up time was 45(0-61) months. Fifteen patients(41.7%) achieved disease progression. While for the patients in HDM group, the median follow-up time was 52(0-75) months. Twenty-two patients(61.1%) achieved disease progression. Conclusion: The BUCY conditioning regimen is a safe and effective therapy for ASCT in patients with MM. Besides, in terms of safety and efficacy, BUCY regimen is not inferior to HDM regimen. BUCY regimen may replace HDM regimen as a standard conditioning regimen for ASCT in MM.

关 键 词：多发性骨髓瘤 自体造血干细胞移植 预处理 白消安 

分 类 号：R733.3[医药卫生—肿瘤]