Stem-cell transplantation in multiple myeloma
Stem-cell transplantation in multiple myeloma
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DOI：
10.1016/j.beha.2005.01.005
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发表时间：
2005-01-01
影响因子：
2.1
通讯作者：
Avet-Loiseau, H
中科院分区：
文献类型：
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作者：
Harousseau, JL;Moreau, P;Avet-Loiseau, H
在新诊断的多发性骨髓瘤（MM）患者中，随机研究表明，自体干细胞移植（ASCT）上级常规化疗，ASCT现在是标准治疗，至少对年轻患者来说是如此。最佳预处理方案为美法仑200 mg/m2，最佳干细胞来源为自体外周祖细胞。IFM 94试验的最新结果表明，至少在一次移植后未达到90%反应的患者中，双重ASCT上级单一ASCT。通过结合生物标志物（β 2-微球蛋白，白蛋白）和遗传标志物（亚二倍体，13号染色体缺失），可以准确预测ASCT后的预后。由于移植死亡率高，异基因SCT的结果仍然令人失望。目前正在研究ASCT和低强度同种异体SCT相结合的策略。
In patient with newly diagnosed multiple myeloma (MM), randomized studies have shown that autologous stem-cell transplantation (ASCT) is superior to conventional chemotherapy, and ASCT is now standard care, at least for younger patients. The best conditioning regimen is melphalan 200 mg/m(2), and the best stem-cell source is unselected peripheral progenitor cells. Recent results of the IFM94 trial show that double ASCT is superior to single ASCT at least in patients who do not achieve a 90% response after one transplant. By combining biologic markers (beta(2)-microglobulin, albumin) and genetic markers (hypodiploidy, chromosome 13 deletion) it is possible to accurately predict prognosis after ASCT The results of allogeneic SCT remain disappointing due to a high transplant mortality. Strategies combining ASCT and reduced-intensity allogeneic SCT are currently being studied.