Maintenance therapy with immunomodulatory drugs after autologous stem cell transplantation in patients with multiple myeloma: a meta-analysis of randomized controlled trials.
Maintenance therapy with immunomodulatory drugs after autologous stem cell transplantation in patients with multiple myeloma: a meta-analysis of randomized controlled trials.
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多发性骨髓瘤患者自体干细胞移植后免疫调节药物维持治疗：随机对照试验的荟萃分析
DOI：
10.1371/journal.pone.0072635
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Li W
中科院分区：
文献类型：
--
作者：
Ye X;Huang J;Pan Q;Li W
背景虽然自体干细胞移植（ASCT）的大剂量治疗（HDT）已被证实比常规化疗的缓解时间更长，但多发性骨髓瘤（MM）仍然无法治愈。ASCT后维持被认为是获得持久缓解和预防肿瘤进展的策略。研究ASCT后免疫调节药物（IMiD）维持治疗的随机对照试验（RCT）显示了一些有价值的生存改善。因此，这项RCT荟萃分析评估了ASCT后IMiD维持治疗对MM患者的影响。方法我们进行了一项荟萃分析，以评估IMiDs（沙利度胺或来那度胺）作为ASCT后维持治疗对新诊断MM患者生存率的影响。该荟萃分析的结局为无进展生存期（PFS）和总生存期（OS）。结果共纳入8项随机对照试验，共3514例患者。ASCT后IMiD维持治疗显示OS明显改善（风险比[HR] 0.75）和显著PFS优势（HR 0.58）。ASCT后沙利度胺维持治疗可导致OS显著获益（HR 0.72），特别是与皮质类固醇联合治疗（HR 0.66）。结论ASCT后MM患者在IMiDs维持治疗下具有显著的总体生存获益。对于接受HDT + ASCT的MM患者，IMiD维持治疗是合理的。
Background Although high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) has been confirmed to result in longer remission time than conventional chemotherapy, multiple myeloma (MM) remains incurable. Post-ASCT maintenance is considered as a strategy for obtaining durable remissions and preventing tumor progression. Randomized controlled trials (RCTs) studying maintenance therapy with immunomodulatory drugs (IMiDs) after ASCT have shown some valuable survival improvements. This meta-analysis of RCTs therefore assesses the effect of post-ASCT IMiDs maintenance on MM patients. Methods We performed a meta-analysis to evaluate the impact of IMiDs (thalidomide or lenalidomide) as post-ASCT maintenance therapy on the survival of newly diagnosed MM patients. The outcomes for this meta-analysis were progression-free survival (PFS) and overall survival (OS). Results Eight RCTs enrolling 3514 patients were included for analysis. An obvious improvement in Os (hazard ratio [HR] 0.75) and a significant PFS advantage (HR 0.58) with post-ASCT IMiDs maintenance was revealed. Thalidomide maintenance after ASCT can result in significant benefit in Os (HR 0.72), particularly combined with corticosteroids (HR 0.66). Conclusions MM patients after ASCT have a significant overall survival benefit with IMiDs maintenance. IMiDs maintenance was justified for MM patients who received HDT with ASCT.
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影响因子：
2.5
作者：
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通讯作者：
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