老年多发性骨髓瘤患者接受自体造血干细胞移植的疗效和安全性:单中心回顾性研究  

Efficacy and safety of autologous hematopoietic stem cell transplantation in elderly multiple myeloma patients:a single center retrospective study

作　　者：黄蓓晖[1] 李娟[1] 邹外一[1] 刘俊茹[1] 谷景立[1] 李晓哲 陈美兰[1] 邝丽芬 Huang Beihui;Li Juan;Zou Waiyi;Liu Junru;Gu Jingli;Li Xiaozhe;Chen Meilan;Kuang Lifen(First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院,广州510080

出　　处：《中华血液学杂志》2022年第2期141-145,共5页Chinese Journal of Hematology

基　　金：国家自然科学基金面上项目(82070220);广东省自然科学基金(2021A1515011715);中山大学临床医学研究5010计划项目(2017005)。

摘　　要：目的评估65岁以上老年多发性骨髓瘤(MM)患者接受自体造血干细胞移植的疗效和安全性。方法回顾性分析自2006年6月1日至2020年7月31日在中山大学附属第一医院诊断并接受含新药诱导方案序贯自体造血干细胞移植的22例65岁以上MM患者的疗效和安全性。接受移植的老年患者均在移植前对重要脏器功能进行评估,自2016年起同时采用国际骨髓瘤工作组虚弱评分评估移植适应证。结果22例患者接受移植时的中位年龄为66.75(IQR 4.50)岁。共20例患者接受了造血干细胞动员,中位采集造血干细胞单个核细胞数为4.53×10^(8)/kg,CD34+细胞数为3.37×10^(6)/kg,中位采集次数2次。造血干细胞回输后中性粒细胞植入中位时间11 d,血小板植入中位时间13 d,移植后100 d治疗相关死亡率为0。中位随访48.7个月,中位无进展生存时间未达到,中位总生存时间为111.8个月。结论对于经过筛选的≥65岁老年MM患者,自体造血干细胞移植是安全有效的治疗方案。Objective To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation(auto-HSCT)in elderly patients(≥65 years old)with multiple myeloma(MM).Methods From June 1,2006 to July 31,2020,22 MM patients(≥65 years old)who were diagnosed in the First Affiliated Hospital,Sun Yat-sen University and received novel drug induction followed by auto-HSCT were analyzed retrospectively.These patients were evaluated for important organ functions before transplantation,and the International Myeloma Working Group frail score was used in 2016 to screen out transplant-eligible patients.Results The median(interquartile range,IQR)age at the time of transplantation of the 22 patients was 66.75(IQR 4.50)years.A total of 20 patients received stem cell mobilization.The median number of mononuclear cells collected was 4.53×10^(8)/kg,that of CD34+cells was 3.37×10^(6)/kg,and the median number of apheresis procedures performed was 2.After stem cell transfusion,the median time of neutrophil implantation was 11 days,that of platelet implantation was 13 days,and the treatment-related mortality was 0 at 100 days after transplantation.The median follow-up was 48.7 months.The median time to progression time was not reached,and the median overall survival time was 111.8 months.Conclusion Auto-HSCT is a safe and effective treatment for selected elderly patients of 65 years or older with MM.

关 键 词：多发性骨髓瘤 老年 自体造血干细胞移植 治疗效果 毒副作用 

分 类 号：R733.3[医药卫生—肿瘤]