Reduced-intensity conditioning allogeneic SCT as salvage treatment for relapsed multiple myeloma
Reduced-intensity conditioning allogeneic SCT as salvage treatment for relapsed multiple myeloma
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DOI：
10.1038/bmt.2008.22
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发表时间：
2008-06-01
影响因子：
4.8
通讯作者：
Mohty, M.
中科院分区：
文献类型：
--
作者：
de Lavallade, H.;El-Cheikh, J.;Mohty, M.
这项回顾性分析的目的是评估32例复发性多发性骨髓瘤（MM）患者队列中的低强度预处理allo SCT（RIC allo-SCT）的获益。共有19名患者有HLA相同的同胞供体（“供体”组），而13名患者没有供体（“无供体”组）。两组患者的预后危险因素差异无统计学意义。来自“供体”组的18名患者实际上可以进行RIC allo-SCT。中位随访时间为36个月（范围：21-60），6例患者死于移植相关毒性（累积发生率：33%（95%CI：11-55%））。18例移植患者中只有4例患者（22%; 95% CI，7-48%）在RIC allo-SCT后进展，而非移植患者中有12例（86%; 95% CI，56-98%; P = 0.0003）。在“意向治疗”分析中，“供体”组的PFS Kaplan-Meier估计值显著高于“无供体”组（P = 0.01; 3年时为46 vs 8%）。在总生存期方面没有差异。然而，在多变量分析中，RIC allo-SCT的实际性能与更好的PFS相关（相对风险，0.35; 95% CI，0.15-0.82; P 0.01）。这些数据表明，RIC allo-SCT在复发性MM的管理中具有潜在获益，需要进一步的前瞻性研究。
The aim of this retrospective analysis was to assess the benefit of reduced-intensity conditioning allo SCT (RIC allo-SCT) in a cohort of 32 relapsed multiple myeloma (MM) patients. A total of 19 patients had an HLA-identical sibling donor ('donor' group), while 13 patients had no donor ('no-donor' group). There were no significant differences between these two groups as for prognosis risk factors. Eighteen patients from the 'donor' group could actually proceed to RIC allo-SCT. With a median follow-up of 36 (range, 21-60) months, six patients died from transplant-related toxicity (cumulative incidence, 33% (95% CI, 11-55%)). Only 4 patients from the 18 transplanted patients (22%; 95% CI, 7-48%) progressed after RIC allo-SCT, as compared to 12 (86%; 95% CI, 56-98%; P = 0.0003) among the nontransplanted patients. In an 'intention-to-treat' analysis, the Kaplan-Meier estimate of PFS was significantly higher in the 'donor' group as compared to the 'no-donor' group (P = 0.01; 46 versus 8% at 3 years). There was no difference in terms of overall survival. However, in multivariate analysis, actual performance of RIC allo-SCT was associated with better PFS (relative risk, 0.35; 95% CI, 0.15-0.82; P 0.01). These data suggest a potential benefit for RIC allo-SCT in the management of relapsed MM warranting further prospective investigations.