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ID:52122216
大小:2.20 MB
页数:93页
时间:2020-04-01
《异基因造血干细胞移植治疗多发性骨髓瘤.ppt》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、AllogeneichaematopoieticcelltransplantationformultiplemyelomaTheallogeneictransplanthastheadvantageovertheautologoustransplantThegraftdoesnotcontaintumorcellsandthepotentialforagraftversusmyeloma(GvM)effectBonemarrowtransplantationinthreepatientswithmultiplemyelom
2、aGahrtonG,RingdénO,LönnqvistB,LindquistR,LjungmanP.ActaMedScand1986;219(5):523-7.瑞典卡罗林斯卡医学院1983MyeloablativeconditioningThreepatientswithmultiplemyelomareceivedbonemarrowgraftsfromHLA-identicalsiblingdonorsOneofthepatients,withIgAkappamyeloma,refractorytoalkeran-p
3、rednisonetherapy,iswellandstillwithoutsignofdisease26monthsposttransplantationAsecondpatientwithBence-Joneskappamyelomaiswell,andskeletalpainandBence-Jonesproteinuriahasdisappeared2monthsaftertransplantation.AthirdpatientwithIgG-lambdamyelomadiedofeffusivepericard
4、itisshortlyaftertransplantation.ActaMedScand1986;219(5):523-7ConclusionBonemarrowtransplantationmaybeindicatedinaselectivegroupofpatientswithmultiplemyelomaActaMedScand1986;219(5):523-7Outof690allogeneticmatchedsiblingdonortransplantsforMM344wereperformedduringthe
5、period1983-93(allwithBM)[group1]356during1994-98(223withBMgroup2and133withPBgroup3)themedianageattransplantationofpatientsingroup1was43years(range21-62)Ingroup2,44years(range18_57)andingroup3,46years(range25_60)TBI+CYtendedtobemorecommonlyusedingroup1(37%)and2(39%
6、)thaningroup3(27%)Melphalancontainingregimestendedtobemorelyusedingroup3MelphalanorBusulphan+CYrarelyConditiongregimeEngraftmentGVHDTreatment–relatedmortalityTreatment–relatedmortalityRelapserateRelapserateSurvivalSurvivalProgression–freesurvivalPFSwassignificantl
7、ybetterforgroup2thanforgroup1(P<0.0001)Withnosignificantlydifferencebetweengroup2and3Causeofdeath75%ingroup1,36%ingroup2,33%ingroup3GVHDFungalARDSOrganfailureCauseofdeaththestudyshowsthattheimprovementisentirelyaresultofalowerTRMduringthelatest5-yearsperiodaGVHDha
8、snochangedduringthisperoidTherewassignificantdifferenceindeathscausedbyIPandbacterialandfungalinfectionConditioningregimeTBI+Melphalanhasnotprevirousbee
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