| Objective: To evaluate the efficacy of autologous peripheral blood stem cell transplantation(APBSCT) for multiple myeloma(MM) patients.Methods: A retrospective analysis of 29 MM cases of ISS staging Ⅰ~ Ⅲ and received the treatment of chemotherapy and APBSC at the union hospital afllliated Fujian medical university from January 2010 to March 2015 were enrolled. All patients received conventional combination chemotherapy before transplantation, 23 cases were treated with bortezomib induction therapy, 6 cases accepted non-bortezomib induction chemotherapy. chemotherapy combined with G-CSF mobilization APBSCT. choose to melphalan-based conditioning regimen, 15 cases of the use of melphalan 200 mg / m2, 6 cases with reduced dose melphalan program(melphalan 120 ~ 160 mg / m2), 5 cases in the melphalan conditioning regimen based on the use of bortezomib, 3 cases of pretreatment using BCV(busulfan, cyclophosphamide, etoposide) program; Date d0reinfusion; both maintenance therapy after transplantation, 22 cases of thalidomide monotherapy maintain, 3 cases of thalidomide plus boron maintain bortezomib, 2 cases thalidomide in combination with interferon maintenance oftransplant,2 cases lenalidomide monotherapy maintain follow-up after analyzing the response rate and survival of transplant.Results: 29 patients after induction, the total effective rate after transplantation is 79%, 86%, respectively, after treatment. The median progression-free survival(progression-free survival, PFS) times were 47 months(range:8~72), median overall survival(overall survival, OS) of 51 months(range:8~72). 29 patients have received hematopoietic reconstitution, neutrophil engraftment with a median time of 12 range:(9-26) days, 8casesof platelet count were not reduced to 20 × 10 9 or less, 21 cases received platelet engraftment. The median time to platelet engraftment was 20(range:15-40) days.29 cases had transplant-related complications, including 15 cases of mouth ulcers and oral infections, 12 cases of pneumonias, 11 cases of intestinalinfections, 3 cases of bloodstream infections and 1 case of skin infections. There were no cases died of transplant-related complications.Assessment was taken away 1-2 month after transplantation, 16 cases(55%) received complete remission(CR), 9cases(31%) received a very good partial response(VGPR), 4 cases(14%) received a partial remission(PR). The median follow-up time was 27(range: 8-72) months. During the follow-up, 11 cases recurred.Among them,2 cases receivedvery good remission after accepting the combinationchemotherapy of bortezomib again. In the end of follow-up, there were 9 cases deaths, 5 cases died of pneumonia, 4cases died of MM disease progression. The CR rates of bortezomib induction chemotherapy group and non-bortezomib induction chemotherapy group was 56.5% and 50.0%, respectively, after transplantation(P = 0.082).In the group of bortezomib induction chemotherapy, the median times of PFS was 49.75 months(range: 8-72);themedian PFS times of non-bortezomib induction chemotherapy group was 39.44(range: 21-54) months, there was significant difference between two groups(P = 0.49).Conclusion: Bortezomib-induced sequential APBSCT longer available disease-free survival. Bortezomib induced sequential APBSCT isamultiple myeloma safe and effective method of treatment, whether to improve long-term survival of patients requires further observation research. |
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