自体造血干细胞移植治疗老年多发性骨髓瘤的单中心回顾性分析  

A single-center retrospective analysis of autologous hematopoietic stem cell transplantation for the treatment of multiplemyeloma in theelderly

作　　者：王婧 施晓兰[2] 金松[2] 颜灵芝[2] 马骁[2] 傅琤琤[2] 吴德沛[2] 商京晶[2] Wang Jing;Shi Xiaolan;Jin Song;Yan Lingzhi;Ma Xiao;Fu Chengcheng;Wu Depei;Shang Jingjing(Department of Hematology,Soochow Hopes Hematology Hospital,Suzhou 215128,China;Department of Hematology,the First Affiliated Hospital of Soochow University,Jiangsu Instituteof Hematology,Suzhou 215006,China)

机构地区：[1]苏州弘慈血液病医院血液科,苏州215128 [2]苏州大学附属第一医院血液科江苏省血液研究所,苏州215006

出　　处：《中华老年医学杂志》2023年第12期1425-1429,共5页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(82270210/H0811)

摘　　要：目的分析65岁以上老年多发性骨髓瘤患者接受自体造血干细胞移植治疗疗效和安全性。方法回顾性分析了自2020年3月1日至2022年10月31日在苏州弘慈血液病医院诊断并接受自体干细胞移植的28例65岁以上多发性骨髓瘤患者的疗效和安全性。接受移植的老年患者在移植前均进行了重要脏器功能评估。结果28例患者接受移植时中位年龄67(66~72)岁,中位采集造血干细胞CD34+细胞数为2.985×10^(6)/kg(2.036~9.5×10^(6)/kg),中位采集天数2(1~3)d;造血干细胞回输后中性粒细胞植入中位时间10(9~14)d,血小板植入中位时间11(10~29)d。中位随访时间25个月,中位无进展生存时间未达到,1年无进展生存期(PFS)率89.3%,2年PFS率76.3%(其中2例行挽救性自体造血干细胞移植患者PFS起点设定为移植前再诱导治疗),中位总生存时间未达到,1年总生存期(OS)率100.0%,2年OS率90.5%。结论对于经过评估筛选的65岁以上的老年多发性骨髓瘤患者,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)for the treatment of multiple myeloma(MM)in elderly patients aged over 65years.Methods In this retrospective analysis,the efficacy and safety of auto-HSCT for the treatment of MM was examined in 28 patients aged>65 years diagnosed and treated at Soochow Hopes Hematology Hospital between March 1,2020 and October 31,2022.The functions of the major organs of these patients were evaluated before transplantation.ResultsThe 28 patients had a median age of 67(66-72)at the time of transplantation,a median number of 2.985×10^(6)/kg(2.036-9.5×10^(6)/kg)of collected CD34+hematopoietic stem cells,and a median number of 2(1-3)days of collection.The median time to neutrophil implantation after hematopoietic stem cell transfusion was 10(9-14)days,and the median platelet implantation time was 11(10-29)days.The median follow-up time was 25 months,but the median progression-free survival time was not reached.The 1-year PFS rate was 89.3%and 2-year PFS rate was 76.3%,with 2 patients starting point of PFS set at the time of pre-transplantation re-induction therapy because needed salvage auto-HSCT.The overall survival time was not reached,the 1-year overall survival rate was 100.0%,and the 2-year overall survival rate was 90.5%.Conclusions Auto-HSCT is a safe and effective treatment for elderly MM patients aged over 65 years after screening and assessment.

关 键 词：多发性骨髓瘤 造血干细胞移植 植入时间 

分 类 号：R733.3[医药卫生—肿瘤] R457.7[医药卫生—临床医学]