High-dose chemoradiotherapy and autologous blood stem cell transplantation in multiple myeloma: results of a phase II trial involving 63 patients.
High-dose chemoradiotherapy and autologous blood stem cell transplantation in multiple myeloma: results of a phase II trial involving 63 patients.
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高剂量放化疗和自体造血干细胞移植治疗多发性骨髓瘤：一项涉及 63 名患者的 II 期试验结果。
DOI：
10.1182/blood.v82.7.2005.2005
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发表时间：
1993
期刊：
影响因子：
20.3
通讯作者：
J. Brouet
中科院分区：
文献类型：
--
作者：
J. Fermand;S. Chevret;Ph. Ravaud;M. Diviné;Véronique Leblond;Francois Dreyfus;Xavier Mariette;J. Brouet
对63例高肿瘤块性多发性骨髓瘤患者进行了自体造血干细胞移植支持下的大剂量化疗和全身照射治疗。在高剂量治疗后，他们被监测了44个月。7名患者因中毒过早死亡。所有其他患者，包括那些对以前的治疗有抵抗力的患者，都显示出肿瘤体积缩小。在移植后6个月，40例（71%）存活患者有微小残留疾病，11例（20%）明显完全缓解。在随访期间，63例患者中有25例（39%）复发，其中16例死亡；31例（49%）持续缓解。移植后的中位总生存期和无事件生存期分别为59个月和43个月。初始血清β 2微球蛋白值（>或< 2.8 mg/L）和既往治疗时间（>或< 6个化疗疗程）是仅有的显著预后因素。在所有存活的患者中，自体造血干细胞移植通常在15天内提供满意和持续的造血重建。因此，高剂量放化疗后自体造血干细胞移植是侵袭性多发性骨髓瘤年轻患者的重要治疗选择。
Sixty-three patients with high tumor mass multiple myeloma were treated with high-dose chemotherapy and total body irradiation supported by autologous blood stem cell transplantation. After high-dose therapy, they were monitored for a median of 44 months. Seven patients died early from toxicity. All the other patients, including those whose disease was resistant to previous therapies, showed a tumor mass reduction. At 6 months postengraftment, 40 (71%) of the surviving patients had minimal residual disease and 11 (20%) were in apparent complete remission. During follow-up, 25 out of the 63 (39%) patients relapsed and 16 of these died; 31 (49%) had a sustained remission. The median overall and event-free survival times after transplantation were 59 and 43 months, respectively. The initial serum beta 2-microglobulin value (> or < 2.8 mg/L) and length of previous therapy (> or < 6 courses of chemotherapy) were the only significant prognostic factors. In all surviving patients, blood stem cell autograft provided satisfactory and sustained haematopoietic reconstitution most often within 15 days. High dose chemoradiotherapy followed by autologous blood stem cell transplantation is thus an important therapeutic option for young patients with aggressive multiple myeloma.