Benefit of autologous stem cell transplantation in multiple myelo-ma patients at different risks after bortezomib- and/or thalido-mide-based induction therapies
10.3969/j.issn.1000-8179.20142173
- VernacularTitle:新药诱导后自体干细胞移植巩固治疗对不同危险度骨髓瘤患者的作用探讨
- Author:
Lili ZHOU
;
Tianmei ZENG
;
Hao XI
;
Weijun FU
;
Juan DU
;
Chunyang ZHANG
;
Hua JIANG
;
Jian HOU
- Publication Type:Journal Article
- Keywords:
multiple myeloma;
autologous hematopoietic stem cell transplantation;
cytogenetics
- From:
Chinese Journal of Clinical Oncology
2015;(1):19-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the benefit of autologous stem cell transplantation (ASCT) as a consolidation therapy in the survival of multiple myeloma (MM) patients at different risks. Methods:A total of 67 MM patients who received ASCT as consolida-tion therapy between August 2006 and July 2011 were enrolled in the retrospective study. The cases were divided into three risk groups on the basis of the International Staging System and fluorescence in situ hybridization. Another 67 patients who accepted consolidation chemotherapy at the same period were selected as case-paired controls matched in terms of age, sex, optimal response after induction, and risk stratifications. All the patients received bortezomib-and/or thalidomide-based induction therapies. Results:No statistical differ-ences in non-complete remission (nCR)/complete remission (CR) rate were observed between the ASCT and chemotherapy groups (44.8%vs. 37.3%, P=0.380) after the induction therapy. The progression-free survival (PFS) was longer in the ASCT group than in the chemotherapy group (32.4 months vs. 15.1 months, P<0.001). The overall survival (OS) was longer in the ASCT group than in the che-motherapy group (58.8 months vs. 42.1 months, P=0.009). both the PFS (median:30.5 months vs. 11.2 months, P<0.001) and the OS (median:85.5 months vs. 34 months, P=0.015) rates were significantly prolonged in the high-risk subgroup after ASCT. In the interme-diate-risk subgroup, neither PFS nor OS showed any significance after ASCT (P>0.05). In the low-risk subgroup, only PFS was extend-ed (median: 34.8 months vs. 17.6 months, P=0.012) after ASCT, without significant improvements in the OS (P>0.05). Conclusion:The MM patients obtained cytogenetic high-risk benefits mostly from ASCT consolidation after inductions based on novel agents.