Prognostic factors in autologous stem cell transplantation for multiple myeloma: an EBMT Registry Study. European Group for Bone Marrow Transplantation.
Prognostic factors in autologous stem cell transplantation for multiple myeloma: an EBMT Registry Study. European Group for Bone Marrow Transplantation.
复制标题
自体干细胞移植治疗多发性骨髓瘤的预后因素：EBMT 登记研究。
作者：
B. Björkstrand;A. H. Goldstone;P. Ljungman;L. Brandt;Salut Brunet;K. Carlson;H. Grant Prentice;Michele Cavo;D. Samson;Antonio De Laurenzi;L. Verdonck;S. Proctor;A. Ferrant;J. Sierra;G. Auzanneau;Xavier Troussard;P. Gravett;Kari Remes;G. Gahrton
1986 年至 1993 年间，欧洲 16 个中心对 130 名多发性骨髓瘤患者进行了自体骨髓和血液祖细胞移植。随访时，77 名患者存活，53 名死亡。 47% 的患者在移植后获得完全缓解。 65 个月的精算生存率为 28%。移植后完全缓解的患者的中位无复发生存期为 29 个月。在单变量分析中，以下因素可预测更长的生存期和无进展情况：男性、年龄小于 45 岁、诊断时血清 β2 微球蛋白值较低、之前仅接受过一种治疗方案、移植前立即对常规化疗有反应以及使用包括美法仑在内的准备方案。最后一个因素，除了诊断时的 I 期疾病、男性性别和移植前立即发生的反应性疾病之外，在多变量分析中也被证明是延长生存期的独立预测变量。与那些有持续疾病迹象的患者相比，移植后完全缓解的患者的无进展生存期明显更好。我们的结论是，高剂量放化疗联合自体干细胞移植可以诱导长期反应，主要是在患有化疗反应性早期疾病的年轻男性患者中。高剂量马法兰，作为单一药物或联合用药，似乎优于其他治疗方案。对于移植前已经完全缓解的患者来说，持续无病的机会似乎最大。
Autologous bone marrow- and blood progenitor cell transplantation was performed in 130 patients with multiple myeloma in 16 European centers between 1986 and 1993. At the time of follow-up, 77 patients were alive and 53 were dead. Complete remission after transplantation was obtained in 47% of all patients. The actuarial survival at 65 months was 28%. The median duration of relapse-free survival among patients who were in complete remission after transplantation was 29 months. The following factors were predictive for longer survival and freedom of progression in a univariate analysis: Male sex, age less than 45 years, a low serum-beta-2-microglobulin value at diagnosis, prior administration of only one treatment regimen, response on conventional chemotherapy immediately pretransplant and the use of a preparative regimen including melphalan. The last factor, in addition to stage I disease at diagnosis, male sex and responsive disease immediately pretransplant, were also demonstrated as independent predictive variables for longer survival in a multivariate analysis. Progression-free survival was significantly better for patients who were in complete remission after transplantation, as compared to those with persisting signs of disease. We conclude that high-dose chemo-radiotherapy with autologous stem cell transplantation can induce long-term responses, primarily in younger, male patients with chemotherapy-responsive early disease. High-dose melphalan, as single drug or in combination, appeared to be superior to other regimens. The chance of being persistently disease-free seemed to be greatest for patients being in complete remission already before the transplantation.
登录
查看更多内容
先前未经治疗的多发性骨髓瘤患者的化疗：近期治疗结果的分析。
影响因子：
4
作者：
Sporn,JR;McIntyre,OR
通讯作者：
McIntyre,OR
多发性骨髓瘤的骨髓移植。
影响因子：
4.8
作者：
Barlogie,B;Gahrton,G
通讯作者：
Gahrton,G
多发性骨髓瘤患者外周血中恶性细胞的检测和定量。
影响因子：
20.3
作者：
Billadeau,D;Quam,L;Thomas,W;Kay,N;Greipp,P;Kyle,R;Oken,MM;VanNess,B
通讯作者：
VanNess,B
采用自体骨髓和造血干细胞支持联合治疗多发性骨髓瘤的低风险强化治疗。
影响因子：
20.3
作者：
Jagannath,S;Vesole,DH;Glenn,L;Crowley,J;Barlogie,B
通讯作者：
Barlogie,B