Donor versus no-donor comparison of newly diagnosed myeloma patients included in the HOVON-50 multiple myeloma study
Donor versus no-donor comparison of newly diagnosed myeloma patients included in the HOVON-50 multiple myeloma study
复制标题
DOI：
10.1182/blood-2011-11-393801
复制
发表时间：
2012-06-28
期刊：
影响因子：
20.3
通讯作者：
Sonneveld, Pieter
中科院分区：
文献类型：
--
作者：
Lokhorst, Henk M.;van der Holt, Bronno;Sonneveld, Pieter
为了前瞻性评价骨髓瘤的异基因干细胞移植（allo-SCT）作为一线治疗的一部分，对HOVON-50研究中接受治疗的患者进行了供体与非供体分析，该研究最初旨在检查沙利度胺联合强化治疗。260例接受自体SCT的患者符合纳入标准，138例患者没有HLA相同的同胞供体，122例患者有供体。中位随访77个月后，两组的完全缓解、无进展生存期（PFS）和总生存期无显著差异。有供体的患者6年PFS为28%，无供体的患者为22%（P = 0.19），高剂量美法仑治疗6年的总生存率为55%，无论是否有供体（P = 0.68）。自体造血干细胞移植后6年的累积非复发死亡率在供者组为16%，而在非供者组为3%（P <0.001）。然而，与继续维持治疗或接受第二次高剂量美法仑的115例患者相比，实际进行allo-SCT的99例患者的PFS显著延长，但这种差异并没有转化为延长生存期的益处。这些结果不支持allo-SCT作为一线治疗的一部分在所有骨髓瘤患者中的普遍应用。（血。2012; 119（26）：6219-6225）
To prospectively evaluate allogeneic stem cell transplantation (allo-SCT) for myeloma as part of first-line therapy, a donor versus no-donor analysis was performed of patients treated in the HOVON-50 study, a study that was originally designed to examine thalidomide combined with intensive therapy. Two hundred sixty patients having received an autologous-SCT fulfilled the criteria to be included, 138 patients without an HLA-identical sibling donor and 122 patients with a donor. After a median follow-up of 77 months, complete remission, progression-free survival (PFS), and overall survival were not significantly different between the 2 groups. PFS at 6 years was 28% for patients with a donor versus 22% for patients without a donor (P = .19) and overall survival at 6 years from high-dose melphalan was 55%, irrespective of having a donor (P = .68). Cumulative incidence of nonrelapse mortality at 6 years after autologous-SCT was 16% in the donor group versus 3% in the no-donor group (P < .001). However, PFS was significantly prolonged in the 99 patients who actually proceeded to allo-SCT compared with the 115 patients who continued maintenance or received a second high-dose melphalan, but the difference did not translate into a prolonged survival benefit. These results do not support a general application of allo-SCT in all myeloma patients as part of first-line therapy. (Blood. 2012; 119(26):6219-6225)