倾向性评分匹配评估RVD方案序贯Auto⁃HSCT在多发性骨髓瘤治疗中的应用研究  

Study on Application of RVD Regimen Sequential Auto⁃HSCT in the Treatment of Multiple Myeloma Evaluated by Propensity Score Matching

作　　者：王洋[1] 薛燕[1] 付春梅 冯凯[1] 李晓林[1] 段雅雅[1] 张慈现[1] 杨宇娟[1] 石浩[1] 付杰[1] 蒙延娜 王晖[1] WANG Yang;XUE Yan;FU Chun-Mei;FENG Kai;LI Xiao-Lin;DUAN Ya-Ya;ZHANG Ci-Xian;YANG Yu-Juan;SHI Hao;FU Jie;MENG Yan-Na;WANG Hui(Department of Hematology,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu Province,China)

机构地区：[1]徐州市中心医院血液科,江苏徐州221009

出　　处：《中国实验血液学杂志》2022年第4期1150-1155,共6页Journal of Experimental Hematology

摘　　要：目的:探讨倾向性评分匹配(PSM)评估来那度胺、硼替佐米及地塞米松(RVD)方案序贯自体造血干细胞移植(Auto⁃HSCT)治疗多发性骨髓瘤(MM)的临床效果。方法:回顾性分析2015年1月-2021年1月本院收治的采用RVD方案治疗且已完成36个月随访的49例MM患者临床资料,纳入对照组;收集同期本医院收治的采用RVD方案序贯Auto⁃HSCT方案治疗且已完成36个月随访的54例MM患者临床资料,纳入观察组。运用PSM法(1∶1,卡钳值=0.01)基于基线资料及实验室指标将对照组与观察组配对,获得组间协变量均衡样本(两组各40例)。比较两组患者治疗18周后的临床疗效、治疗期间的毒副反应发生率及随访36个月的生存状况。结果:观察组的ORR、DCR均明显高于对照组(P<0.05)。两组患者的疲乏、皮疹、血小板减少、贫血、恶心等发生率比较,差异无统计学意义(P>0.05)。随访36个月(随访期间无失访),观察组病死4例,生存率为90%,平均生存时间35.61(95%CI:35.541-35.685)个月,对照组病死10例,生存率为75%,平均生存时间34.70(95%CI:34.559-34.832)个月,观察组生存率明显高于对照组(P<0.05)。结论:RVD方案序贯Auto⁃HSCT治疗MM可以提高近期疗效,提高患者的生存率,且不增加毒副反应,安全性较好。Objective:To investigate the application effect of sequential autologous hematopoietic stem cell transplantation(Auto⁃HSCT)with lenalidomide,bortezomib and dexamethasone(RVD)in the treatment of multiple myeloma(MM)evaluated by propensity score matching.Methods:The clinical data of 49 MM patients treated with RVD scheme and followed⁃up for 36 months in the hospital from January 2015 to January 2021 were retrospectively analyzed and included in the control group,the clinical data of 54 MM patients who received RVD scheme and sequential Auto⁃HSCT scheme and completed 36 months of follow⁃up in the hospital during the same period were collected and included in the observation group.PSM method(1∶1,caliper value=0.01)was used to match the control group with the observation group based on baseline data and laboratory indexes,covariate equilibrium samples were obtained between groups(40 cases in each group).The clinical efficacy of patients in the two groups after 18 weeks of treatment was compared;the incidence of toxic and side effects during treatment of patients in the two groups was compared;the survival of patients in the two groups was compared after 36 months of follow⁃up.Results:The ORR and DCR in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).Compared the incidence of fatigue,rash,thrombocytopenia,anemia and nausea of patients in the two groups,there was no statistical significant difference(P>0.05).After 36 months of follow⁃up(no loss during follow⁃up),4 cases died from illness in the observation group,with a survival rate of 90%and an average survival time of 35.61(95%CI:35.541-35.685)months,10 cases died from illness in the control group,with a survival rate of 75%and an average survival time of 34.70(95%CI:34.559-34.832)months,the survival rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Sequential Auto⁃HSCT with RVD regimen in the tr

关 键 词：多发性骨髓瘤 来那度胺 硼替佐米 地塞米松 自体造血干细胞移植 毒副反应 

分 类 号：R733.3[医药卫生—肿瘤]