【摘要】 目的评价异基因造血干细胞移植治疗多发性骨髓瘤(MM)的临床疗效。方法回顾分析2007年1月～2012年3月期间,笔者医院开展的异基因造血干细胞移植(allo-HSCT)治疗多发性骨髓瘤5例,其中3例为HLA全相合同胞供者,2例为HLA全相合非亲缘供者。例1采用环磷酰胺联合大剂量马法兰用于预处理方案,其余4例采用硼替佐米联合大剂量马法兰用于预处理方案,其中1例非亲缘加用抗胸腺细胞免疫球蛋白(ATG)。预防移植物抗宿主病(GVHD)采用环孢素A(CsA)联合短疗程甲氨蝶呤(MTX)的经典方案。结果 5例患者allo-HSCT后均获得造血重建,中位随访时间32.3(1.7～63)个月。1例死于aGVHD,1例于移植后44个月复发,目前仍维持治疗中。其余3例目前仍完全缓解,患者最长无病生存时间已达63个月。结论 Allo-HSCT是治愈年轻MM患者的有效方法,使患者获得长期生存。更多还原

【Abstract】 Objective To evaluate the curative effect of allogeneic hematopoietic stem cell transplantation(allo-HSCT) for multiple myeloma(MM).Methods A retrospective analysis on 5 patients with multiple myeloma treated with allo-HSCT from January 2007 to March 2012 was conducted.Sibling HLA identical allogeneic hematopoietic stem cell transplantations were underwent in 5 cases.The conditioning regimen for case 1 was cyclophosphamide plus high-dose melphalan,while other 4 cases were bortezomib plus high-dose melphalan,of which 1 case of unrelated donor add anti-human thymocyte globulin(ATG).Cyclosporine A(CsA)combined with methotrexate(MTX) were used to preventgraft-versus-host disease(GVHD).Results Hematopoiectic reconstruction were observed in all patients treated with allo-HSCT.One patient was died of acute graft-versus-host disease(aGVHD).The median follow-up duration was 32.3 months(from 1.7 to 63 months).Relapse occurred in 1 patient 44 months later after transplantation,now is still in treatment.The other 3 patients now are still incomplete remission(CR).The most long time now is 63 months.Conclusion Our data shows that the allo-ASCT from HLA-antigen matched related or unrelated donors is a treatment modality with curative potential for yonger myeloma patients.It can prolong the patient′s life.更多还原