Analysis of Curative Efficacy of Different Chemotherapy Regimen Combined with Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation on Multiple Myeloma.
10.7534/j.issn.1009-2137.2018.06.016
- Author:
Cun-Bang WANG
1
;
Hai BAI
2
;
Rui XI
1
;
Yao-Zhu PAN
1
;
Tao WU
1
;
Shu-Fen XU
1
;
Qian ZHANG
1
;
Jin-Mao ZHOU
1
;
Ya CHEN
1
Author Information
1. Department of Hematology, Lanzhou General Hospital, Chinese PLA, Lanzhou 730050, Gansu Province, China.
2. Department of Hematology, Lanzhou General Hospital, Chinese PLA, Lanzhou 730050, Gansu Province, China.E-mail:baihai98@tom.com.
- Publication Type:Journal Article
- MeSH:
Antineoplastic Combined Chemotherapy Protocols;
Disease-Free Survival;
Hematopoietic Stem Cell Transplantation;
Humans;
Multiple Myeloma;
therapy;
Peripheral Blood Stem Cell Transplantation;
Transplantation, Autologous;
Treatment Outcome
- From:
Journal of Experimental Hematology
2018;26(6):1675-1680
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) on patients with multiple myeloma( MM) after Sequential different chemotherapy.
METHODS:Seven cases of patients with MM were included in the A group, and 14 cases of patients received 4-6 courses of chemotherapy with VAD and MP before transplantation were included in the B group and received 4-6 courses of chemotherapy with VTD and VD before transplantation. Auto-peripheral blood hematopoietic stem cell were mobilized by G-CSF. Condition regimen were melphalan(A group) or bortezomib combined melphalan(B group). IFN-α(A group) or Thalidomide(B group) was used as maintenance treatment after auto-PBHSCT.
RESULTS:Two cases of patients reached to complete remission (CR)(2/7,28.6%),1 case got very good partial remission (VGPR) (1/7,14.3%), 4 cases got partial remission(PR) (4/7,57.1%) in A group, and 9 cases got CR (9/14,64.3%), 3 cases got VGPR(3/14,21.4%), and 2 cases got PR(2/14,14.3%) in the B group before auto-PBHSCT. The CR and VGPR were significant difference between 2 groups (P<0.05). All the patients got hematopoietic recovery. In 2 groups, the median time of ANC recovery≥0.5×10/L was 13 (11-16) and 14（11-18）days, that of WBC recovery ≥4.0×10/L were 16(15-19) and 18(16-20)days, Plt recovery ≥ 50 ×10/L was 21 (18-25) and 21(17-25) days. Bone marrow showed CR in 21 to 28 days after transplantation. All of 7 cases of patients remised in 6 to 47 months after transplantation, and 4 cases died lastly and 3 cases failed to be followed up in A group. The median time of progression-free survival(PFS) was 36(6-47) months, and that of overall survival(OS) was 37(7-50) months. In B group, 2 cases of patients remissed in 5 and 17 months after transplantation, and did lastly, 1 case relieved in 12 months after transplantation and failed to be followed up. 1 case of patient relived in 46 months after transplantation, and then received the second auto-PBHSCT, and got CR for 105 months. Other 10 cases got CR, their median time of PFS was 45.5(4-105) months, the median time of overall survival(OS) was 45.5(4-105) months. The PFS and OS were very significant different between 2 groups (P<0.01).
CONCLUSION:Bortezomib-based chemotherapy, Auto-PBHSCT and maintenance treatment with thalidomide were favorable to the patients of MM for survival prolongation.
