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异基因造血干细胞移植在年轻多发性骨髓瘤患者治疗中的应用

Application of Allogeneic Stem Cell Transplantation in Younger Patients with Multiple Myeloma

  • 摘要: 目的 探讨异基因造血干细胞移植在年轻多发性骨髓瘤治疗中的疗效及安全性。 方法 回顾性分析我科2003年4月至2012年6月行清髓异基因造血干细胞移植(allo-SCT)的22例多发性骨髓瘤患者,中位年龄为44.5岁(30~54岁)。所有患者随访至2012年10月。中位随访时间11月(0.9~92月)。 结果 22例患者移植前完全缓解率为13.6%,移植后完全缓解率达63.6%。100天内移植相关死亡率(TRM)为9.1%。1年内TRM为22.7%。1年内的复发率为13.6%。随访期内总生存率为68.2%,无进展生存率为50%。多因素分析未显示年龄、性别、移植前缓解状态及诊断至移植时长是影响总生存期的独立危险因素。 结论 清髓的异基因造血干细胞移植用于年轻多发性骨髓瘤患者具有较好的疗效及安全性,且一年内复发率较低。

     

    Abstract: Objective To analyze the efficiency, safety and prognosis of allogeneic stem cell transplantation in patients with multiple myeloma. Methods A retrospective analyze was performed on clinical data of 22 patients from April 2003 to June 2012 who received myeloablative allogeneic stem cell transplantation. The median age of these patients was 44.5 years (range, 28-82 years).All the patients were followed up to October 2012.The median follow-up time was 11 months(range,0.9-92 months). Results The complete remission(CR) rate before and after transplantation was 13.6% and 63.6% respectively. The transplant-related mortality was 9.1% within first 100 days and 22.7% in the first year. The relapse rate of first year was 13.6%. The total survival rate was 68.2% and progression-free rate was 50%.Multivariate analysis showed age, sexuality, remission status and periods between diagnosis and transplantation were not the independent risk factor of prognosis. Conclusion Myeloablative allogeneic stem cell transplantation was an efficient and safety therapy with decreased relapse rate of first year in young patients with multiple myeloma.

     

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