异基因造血干细胞移植治疗多发性骨髓瘤

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1、AllogeneichaematopoieticcelltransplantationformultiplemyelomaTheallogeneictransplanthastheadvantageovertheautologoustransplantThegraftdoesnotcontaintumorcellsandthepotentialforagraftversusmyeloma(GvM)effectBonemarrowtransplantationinthreepatientswithmultiplemyelomaGahrtonG,RingdénO,LönnqvistB,L

2、indquistR,LjungmanP.ActaMedScand1986;219(5):523-7.瑞典卡罗林斯卡医学院1983MyeloablativeconditioningThreepatientswithmultiplemyelomareceivedbonemarrowgraftsfromHLA-identicalsiblingdonorsOneofthepatients,withIgAkappamyeloma,refractorytoalkeran-prednisonetherapy,iswellandstillwithoutsignofdisease26monthspos

3、ttransplantationAsecondpatientwithBence-Joneskappamyelomaiswell,andskeletalpainandBence-Jonesproteinuriahasdisappeared2monthsaftertransplantation.AthirdpatientwithIgG-lambdamyelomadiedofeffusivepericarditisshortlyaftertransplantation.ActaMedScand1986;219(5):523-7ConclusionBonemarrowtransplantat

4、ionmaybeindicatedinaselectivegroupofpatientswithmultiplemyelomaActaMedScand1986;219(5):523-7Outof690allogeneticmatchedsiblingdonortransplantsforMM344wereperformedduringtheperiod1983-93(allwithBM)[group1]356during1994-98(223withBMgroup2and133withPBgroup3)themedianageattransplantationofpatientsin

5、group1was43years(range21-62)Ingroup2,44years(range18_57)andingroup3,46years(range25_60)TBI+CYtendedtobemorecommonlyusedingroup1(37%)and2(39%)thaningroup3(27%)Melphalancontainingregimestendedtobemorelyusedingroup3MelphalanorBusulphan+CYrarelyConditiongregimeEngraftmentGVHDTreatment–relatedmortal

6、ityTreatment–relatedmortalityRelapserateRelapserateSurvivalSurvivalProgression–freesurvivalPFSwassignificantlybetterforgroup2thanforgroup1(P＜0.0001)Withnosignificantlydifferencebetweengroup2and3Causeofdeath75%ingroup1,36%ingroup2,33%ingroup3GVHDFungalARDSOrganfailureCauseofdeaththestudyshowstha

7、ttheimprovementisentirelyaresultofalowerTRMduringthelatest5-yearsperiodaGVHDhasnochangedduringthisperoidTherewassignificantdifferenceindeathscausedbyIPandbacterialandfungalinfectionConditioningregimeTBI+Melphalanhasnotprevirousbee