%0 English Abstract
%T [Clinical analysis of 14 patients aged ≤ 50 years with high-risk multiple myeloma treated with allogeneic hematopoietic stem cell transplantation].
%A Pan P
%A Wang JL
%A Zhai WH
%A Ma QL
%A Yang DL
%A Feng SZ
%A Han MZ
%A Pang AM
%A Jiang EL
%J Zhonghua Xue Ye Xue Za Zhi
%V 45
%N 1
%D 2024 Jan 14
%M 38527835
暂无%R 10.3760/cma.j.cn121090-20230928-00148
%X Objective: To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in young patients with high-risk multiple myeloma (HRMM) and analyzed the factors affecting patient prognosis. Methods: In this retrospective study, we analyzed the clinical data of 14 patients with HRMM with cytogenetic abnormalities or high-risk biological factors who underwent allo-HSCT at the Hematopoietic Stem Cell Transplantation Center of the Institute of Hematology & Blood Diseases Hospital between November 2016 and November 2022. Results: There were seven males and seven females included in the study, with a median age of 39.5 (31-50) years at the time of allo-HSCT. The median number of treatment lines before transplantation was 2 (1-6) . Before allo-HSCT, 42.9% (6/14) of the patients did not achieve complete remission, while 35.7% (5/14) of the patients achieved measurable residual disease positivity. After transplantation, all patients were evaluated for their treatment response, and the overall response rate was 100% (14/14) . All 14 patients successfully underwent allo-HSCT, with median engraftment times for neutrophils and platelets of 11 (10-14) days and 13 (9-103) days, respectively. Acute grade Ⅱ-Ⅳ graft-versus-host disease (GVHD) occurred in five patients (35.7%) , and two patients (14.3%) developed moderate-to-severe chronic GVHD. The median follow-up time after allo-HSCT was 18.93 (4.10-72.53) months, with an expected 2-year transplant-related mortality rate of 7.1% (95% CI 0%-21.1%) and an expected 2-year overall survival rate of 92.9% (95% CI 80.3%-100.0%) . Moreover, the expected 1-year and 2-year progression-free survival rates were 92.9% (95% CI 80.3%-100.0%) and 66.0% (95% CI 39.4%-100.0%) , respectively, and the 2-year cumulative incidence of relapse was 28.9% (95% CI 0%-56.7%) . Upfront allo-HSCT following complete remission after induced therapy and the presence of chronic GVHD might be favorable prognostic factors. Conclusion: allo-HSCT is an effective treatment for improving the prognosis of young patients with HRMM.<BR>目的： 观察异基因造血干细胞移植（allo-HSCT）对年轻（≤50岁）高危多发性骨髓瘤（HRMM）患者的疗效。 方法： 纳入2016年11月至2022年11月期间于中国医学科学院血液病医院造血干细胞移植中心接受allo-HSCT的14例具有高危细胞遗传学改变或高危疾病生物学因素的年轻（≤50岁）HRMM患者，对其临床资料进行回顾性分析。 结果： 14例患者中，男7例，女7例，移植时中位年龄为39.5（31～50）岁。患者移植前中位治疗线数为2（1～6）线，移植前6例患者未达完全缓解（CR），5例患者微小残留病（MRD）阳性。14例患者均获得造血重建，中性粒细胞、血小板中位植入时间分别为11（10～14）d、13（9～103）d。5例患者发生Ⅱ～Ⅳ度急性移植物抗宿主病（GVHD），2例患者发生中重度慢性GVHD。移植后3个月疗效评估，所有患者均为严格意义的完全缓解（sCR）。移植后中位随访时间为18.9（4.1～72.5）个月，移植后2年移植相关死亡率为7.1%（95% CI 0%～21.1%），总生存率为92.9%（95% CI 80.3%～100.0%）；移植后1、2年无进展生存率分别为92.9%（95%CI 80.3%～100.0%）、66.0%（95%CI 39.4%～100.0%），2年累积复发率为28.9%（95%CI 0%～56.7%）。 结论： 年轻HRMM患者在诱导治疗后桥接allo-HSCT可进一步提高疗效。.