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。
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/（m^2 · d） for two days and VP-16 500 mg/d for two days, G-CSF 300 μg/d when white blood cell （WBC）（1.0× 10^9/L for about 6 -9 days. APBSC were collected when WBC：〉4.0 × 10^9/L and platelate〉50 × 10^9/L. The conditioning regimen were melphalan （M） 200 mg/m^2 or M 140 mg/m^2 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） × 10^5/kg. The CD34＋ cells in harvest were 4.75 （1.69 - 23.15） × 10^6/kg. CFU-GM colony were 84.5 （5.43 - 300.4 ）/10^4 cells. The mean time of neutrophil recovering to 0.5 × 10^9/L after APBSCT was ＋9.5 days. Of the eight patients six achieved 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.
出处
《临床血液学杂志》
CAS
2006年第3期131-132,136,共3页
Journal of Clinical Hematology
关键词
多发性骨髓瘤
自体外周造血干细胞移植
动员
预处理
Multiple myeloma
Autologous peripheral blood stem cell transplantation
Mobilization
Conditioning
