多发性骨髓瘤自体移植及维持治疗的效果  

The effect of autologous transplantation and maintenance therapy in multiple myeloma

作　　者：黄燕[1] 崔文婷[1] 胡苏[1] 欧阳鹏[1] 冯波 HUANG Yan;CUI Wenting;HU Su;OUYANG Peng;FENG Bo(Department of Hematology,General Hospital,Jiujiang First People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院总院血液科,江西九江332000

出　　处：《当代医学》2022年第24期102-104,共3页Contemporary Medicine

基　　金：江西省卫生健康委科技计划项目(20204208)。

摘　　要：目的探讨多发性骨髓瘤(MM)自体移植及维持治疗的效果。方法选取2013年6月至2015年6月本院收治的37例MM患者作为研究对象,均给予BCV预处理方案(白消安+环磷酰胺+依托泊苷),继续筛选合适的研究患者,给予自体造血干细胞移植,移植后使用来那度胺联合白细胞介素2维持治疗。记录造血重建、不良反应发生情况、移植后总体生存期(OS)和无进展生存期(PFS)、复发情况。结果回输的移植物中位CD34+计数和单个核细胞数分别为4.69(1.20~9.98)×10^(6)/kg、6.30(3.22~12.34)×10^(8)/kg;37例患者均获得造血重建,血小板重建时间为7~21 d,平均(7.32±1.21)d;中性粒细胞重建时间为5~20 d,平均(10.48±1.12)d。37例患者中出现呕吐9例(24.32%)、恶心13例(35.14%)、骨髓抑制2例(5.41%)、脱发8例(21.62%)、口腔溃疡2例(5.41%)、感染10例(27.03%)、腹泻7例(18.92%)、纳差8例(21.62%),无移植相关死亡,经对症治疗、抗感染治疗后,不良反应均减轻、好转;有8例(21.62%)复发。所有患者均随访5年,截至随访日期,3年、5年PFS率分别为58.75%、45.20%;3年、5年OS率分别为82.10%、69.45%。结论自体移植及维持治疗是治疗MM的有效方案,可延长患者的PFS和OS,降低复发率。Objective To investigate the effect of autologous transplantation and maintenance therapy in multiple myeloma(MM).Methods 37 patients with MM who were admitted to our hospital from June 2013 to June 2015 were selected as the research subjects.All patients were treated with BCV conditioning regimen(busulfan+cyclophosphamide+etoposide),autologous hematopoietic stem cell transplantation,followed by maintenance therapy with lenalidomide combined with interleukin-2.The hematopoietic reconstruction,adverse reactions,overall survival(OS)and progression-free survival(PFS)after transplantation and recurrence were recorded.Results The median CD34+count and mononuclear cell count of the reinfused grafts were 4.69(1.20-9.98)×10^(6)/kg and 6.30(3.22-12.34)×10^(8)/kg,respectively.Hematopoietic reconstruction was achieved in all 37 patients,and the platelet reconstruction time was 7-21 d,average(7.32±1.21)d;the neutrophil reconstitution time was 5-20 d,average(10.48±1.12)d.Among the 37 patients,9 cases(24.32%)of vomiting,13 cases(35.14%)of nausea,2 cases of bone marrow suppression(5.41%),8 cases of hair loss(21.62%),2 cases of oral ulcers(5.41%),and 10 cases of infection(27.03%),7 cases of diarrhea(18.92%),8 cases of anorexia(21.62%),and no transplant-related death.After symptomatic treatment and anti-infection treatment,the adverse reactions were alleviated and improved;8 cases(21.62%)relapse.All patients were followed up for 5 years.As of the follow-up date,the 3-year and 5-year PFS rates were 58.75%and 45.20%,respectively;the 3-year and 5-year OS rates were 82.10%and 69.45%,respectively.Conclusion Autologous transplantation and maintenance therapy are effective options for the treatment of MM,which can prolong the PFS and OS of patients and reduce the recurrence rate.

关 键 词：多发性骨髓瘤 自体造血干细胞移植 来那度胺 BCV预处理方案 

分 类 号：R733.3[医药卫生—肿瘤]