【摘要】 目的:评价环磷酰胺(Cy)联合足叶乙苷(VP-16)和粒细胞集落刺激因子(G-CSF)方案干细胞动员效果及自体外周血造血干细胞移植(APBSCT)治疗多发性骨髓瘤(MM)的临床疗效。方法:8例MM患者给予Cy联合VP-16化疗加G-CSF动员造血干细胞,Cy 1 000-1 200 mg／(m2·d)×2 d,VP-16 500 mg／d×2 d,白细胞(WBC)<1．0×109／L后给G-CSF 300μg／d×6-9 d。当WBC>4．0×109／L,血小板>50×109／L后采集APBSC。采用2种预处理方案,马法兰200 mg／m2或140 mg／m2联合VP-16 1 000 mg及司莫司汀200 mg。结果:动员后采集的单个核细胞(MNC)为6．23(4．27-12．78)×108／kg;CD34+细胞为4．75(1．69-23．15)×106／kg;粒细胞-巨噬细胞集落形成单位(CFU-GM)集落为84．5(5．4-300．4)个／104细胞。APBSCT后中性粒细胞恢复至>0．5×109／L的中位时间+9．5 d。在8例患者中,6例获得完全缓解,1例部分缓解,1例未缓解。中位生存期46(23-54)个月,中位无病生存期12(0-39)个月。结论:Cy联合VP-16加G-CSF作为动员方案,能够采集足够量的APBSC;APBCST治疗MM安全有效。更多还原

【Abstract】 Objective: To evaluate the efficacy of autologous peripheral stem cell transplantation (APBSCT) for treatment of eight cases with multiple myeloma (MM). To evaluate the mobilization regimen of cyclophosphamide (Cy)and Etoposide (VP-16) combined with granulocyte colony stimulating factor (G-CSF). Method:Eight patients with MM were mobilized by combined chemotherapy and G-CSF regimen, Cy 1 000-1 200 mg/(m2·d) for two days and VP-16 500 mg/d for two days, G-CSF 300μg/d when white blood cell (WBC)<1.0×109/L for about 6 -9 days. APBSC were collected when WBC>4. 0×109/L and platelate>50×109/L. The conditioning regimen were melphalan (M) 200 mg/m2 or M 140 mg/m2 combined with VP-16 1 000 mg and carmustine (BCNU) 200 mg. Result:The amount of mononuclear cells (MNC) in harvest were 6. 2(4. 27 - 12. 78)×108/kg. The CD34 + cells in harvest were 4. 75(1.69-23. 15)×106/kg. CFU-GM colony were 84. 5 (5. 43 - 300. 4)/104 cells. The mean time of neutrophil recovering to 0. 5×109/L after APBSCT was +9. 5 days. Of the eight patients six a-chieved complete response (CR) , one patient had partial response (PR) , one patient had no response(NR). The mean overall survival (OS) is 46 months, the mean disease free survival (DFS) is 12 months. Conclusion:The mobilizing regimen is effective. APBSCT is an efficient and safe way for MM.更多还原