医学
多发性骨髓瘤
硼替佐米
地塞米松
来那度胺
肿瘤科
内科学
自体干细胞移植
梅尔法兰
移植
干细胞
造血干细胞移植
沙利度胺
Carfilzomib公司
作者
Shanhao Tang,Yin Lu,Pisheng Zhang,Dong Chen,Xuhui Liu,Xiaohong Du,Junjie Cao,Peipei Ye,Lieguang Chen,Shuangyue Li,Keya Sha,Xian xu Zhuang,Yiyu Xie,Xiaojin Wu,Renzhi Pei
标识
DOI:10.1016/j.leukres.2021.106710
摘要
In order to investigate the efficacy of lenalidomide, bortezomib and dexamethasone (VRD) induction chemotherapy regimen combined with tandem autologous stem cell transplantation (ASCT) in treating multi-hit multiple myeloma (MM), we analyzed 252 cases of newly diagnosed MM treated with the bortezomib-containing induction chemotherapy from June 2016 to June 2019. According to the fluorescence in situ hybridization (FISH) results on diagnosis, the patients were divided into multi-hit MM group (47 cases), single-hit MM group (81 cases), and standard-risk group (124 cases). Our analysis showed that R-ISS stageⅢ in transplantation group and R-ISS stageⅢ, multi-hit and VGPR or above was not achieved at the fourth cycle of chemotherapy in non-transplantation group were independent factors for poor prognosis by univariate and multivariate analyses. Moreover, the overall response rate (ORR) of VRD induction chemotherapy group was significantly higher than that of the non-VRD group in the single-hit and multi-hit groups (P = 0.021, P = 0.032); In terms of ASCT, tandem-ASCT can significantly improve the 2-year PFS (77.8 ± 3.9 %) and OS (83.3 ± 5.6 %) of multi-hit MM (P = 0.024, P = 0.037), while single-ASCT only has a limited effect on PFS (61.5 ± 3.0 %) and OS (71.9 ± 4.5 %) (P = 0.115, P = 0.155).
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