Prognostic factors for survival after autologous transplantation: a single centre experience in 133 multiple myeloma patients
Prognostic factors for survival after autologous transplantation: a single centre experience in 133 multiple myeloma patients
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DOI：
10.1038/sj.bmt.1704728
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发表时间：
2005-01-01
影响因子：
4.8
通讯作者：
Vorlicek, J
中科院分区：
文献类型：
--
作者：
Krejci, M;Buchler, T;Vorlicek, J
自体干细胞移植（ASCT）在治疗症状性多发性骨髓瘤（MM）中具有明确的作用。我们的目的是分析选择的预后参数对ASCT后MM患者生存的影响。新的国际分级系统（ISS）也进行了评估。1995年至2002年间，共有133例MM患者在我中心接受了移植手术。ASCT后，35%的患者完全缓解（CR）， 60%的患者部分缓解（PR）。移植的中位无进展生存期（PFS）和总生存期（OS）分别为29.5个月和68.8个月。移植相关死亡率（TRM）为3%。在多因素分析中，与显著缩短OS相关的因素是移植后缺乏CR （P = 0.002，风险比（HR）： 3.1）、ISS 3期（P = 0.001，风险比（HR）： 3.0）和移植时年龄超过60岁（P = 0.035，风险比：2.0）。ASCT前的疾病状况对移植后的PFS和OS无显著影响。我们得出结论，ASCT是MM患者安全有效的手术，与低TRM相关。ASCT后的生存取决于ASCT后的反应，根据ISS的分期和年龄。
Autologous stem cell transplantation ( ASCT) has an established role in the treatment of symptomatic multiple myeloma ( MM). Our aim was to analyse the impact of selected prognostic parameters on the survival of patients with MM after ASCT. The new International Staging System ( ISS) was also evaluated. A total of 133 MM patients were transplanted in our centre between 1995 and 2002. Following ASCT, 35% of patients were in complete remission (CR) and 60% were in partial remission ( PR). The median progression-free (PFS) and overall ( OS) survival from transplantation were 29.5 and 68.8 months, respectively. Transplant-related mortality (TRM) was 3%. On multivariate analysis, factors associated with significantly shorter OS were lack of CR after transplant ( P = 0.002, hazard ratio (HR): 3.1), stage 3 according to ISS ( P = 0.001, HR: 3.0) and age at transplant over 60 years ( P = 0.035, HR: 2.0). The status of disease before ASCT did not significantly affect PFS and OS after transplantation. We conclude that ASCT is a safe and effective procedure in MM patients, associated with low TRM. The survival after ASCT was dependent on response after ASCT, stage according to ISS and age.