Post-transplant immunotherapy with donor-lymphocyte infusion and novel agents to upgrade partial into complete and molecular remission in allografted patients with multiple myeloma
Post-transplant immunotherapy with donor-lymphocyte infusion and novel agents to upgrade partial into complete and molecular remission in allografted patients with multiple myeloma
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DOI：
10.1016/j.exphem.2009.03.008
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发表时间：
2009-07-01
影响因子：
2.6
通讯作者：
Zander, Axel
中科院分区：
文献类型：
--
作者：
Kroeger, Nicolaus;Badbaran, Anita;Zander, Axel
Objective.研究移植后免疫治疗，逐步增加供体淋巴细胞输注（DLI）和新的药物（沙利度胺，硼替佐米，来那度胺），以达到完全缓解（CR）。32例多发性骨髓瘤患者在异基因干细胞移植后仅获得部分缓解，接受DLI治疗。如果未达到CR，则添加一种新药物以达到CR。根据欧洲血液和骨髓移植组标准、流式细胞术或分子方法（通过患者特异性免疫球蛋白H-聚合酶链反应或浆细胞嵌合体聚合酶链反应评估）定义的CR分别在59%、63%和50%的患者中实现。根据欧洲血液和骨髓移植组标准，实现CR可改善5年无进展生存率和总生存率（53% vs 35%; p = 0.03和90% vs 62%; p = 0.06），流式细胞术（74%对15%; p = 0.001和100%对52%; p = 0.1）或分子方法（84%对38%; p = 0.001和100%对71%; p = 0.03）。我们的研究结果表明，移植后治疗的临床相关性，以提高缓解，缓解的深度为长期生存的骨髓瘤患者。(C)2009 ISEH -血液学和干细胞学会。爱思唯尔公司出版
Objective. To investigate post-transplant immunotherapy with escalating donor-lymphocyte infusions (DLI) and novel agents (thalidomide, bortezomib, and lenalidomide) to target complete remission (CR).Materials and Methods. Thirty-two patients with multiple myeloma who achieved only partial remission after allogeneic stem cell transplantation were treated with DLI. If no CR was achieved, one of the novel agents was added to target CR.Results. CR defined either by European Group for Blood and Marrow Transplantation criteria, flow cytometry, or molecular methods as assessed by patient-specific immunoglobulin H-polymerase chain reaction or plasma cell chimerism polymerase chain reaction was accomplished in 59%, 63%, and 50% of patients, respectively. Achievement of CR resulted in improved 5-year progressive-free and overall survival, according to European Group for Blood and Marrow Transplantation criteria (53% vs 35%; p = 0.03 and 90% vs 62%; p = 0.06), flow cytometry (74% vs 15%; p = 0.001 and 100% vs 52%; p = 0.1), or molecular methods (84% vs 38%; p = 0.001 and 100% vs 71 %; p = 0.03).Conclusions. Our finding demonstrates the clinical relevance of posttransplantation therapies to upgrade remission, and of remission's depth for long-term survival in myeloma patients. (C) 2009 ISEH - Society for Hematology and Stem Cells. Published by Elsevier Inc.