自体造血干细胞移植是适合移植的多发性骨髓瘤患者的标准治疗?
|
摘要
自体造血干细胞移植(autologous stem cell transplantation,ASCT)是多发性骨髓瘤的标准治疗策略之一。不论是传统药物时代,还是新药时代,ASCT均作为多发性骨髓瘤治疗的重要手段之一。尽管文献报道ASCT可延长患者的无进展生存期,但对总生存期的获益有待进一步探讨,特别是高危患者,ASCT可能并不能使患者获益。此外,ASCT后的巩固、维持治疗对预后也至关重要,且ASCT具有存在相关不良反应以及再发肿瘤的风险,故ASCT用于多发性骨髓瘤治疗的价值仍有待商榷。
Autologous stem cell transplantation( ASCT) is a standard choice for the treatment of multiple myeloma( MM). ASCT is an important therapy for MM not only in the era of classical drugs but also in the times of new medicines. As literature reported,the length of progression-free survival of MM patients can be extended by ASCT. But the effect of ASCT on the overall survival is still unknown,especially for high-risk patients with cytogenetic abnormalities. Consolidation and maintenance after the ASCT is very important to maintain the effects of ASCT. It is necessary to be aware of the side effects and second primary malignances after ASCT.
Autologous stem cell transplantation( ASCT) is a standard choice for the treatment of multiple myeloma( MM). ASCT is an important therapy for MM not only in the era of classical drugs but also in the times of new medicines. As literature reported,the length of progression-free survival of MM patients can be extended by ASCT. But the effect of ASCT on the overall survival is still unknown,especially for high-risk patients with cytogenetic abnormalities. Consolidation and maintenance after the ASCT is very important to maintain the effects of ASCT. It is necessary to be aware of the side effects and second primary malignances after ASCT.
引文
[1]Blokhin N,Larionov L,Perevodchikova N,et al.[Clinical experiences with sarcolysin in neoplastic diseases][J].Ann N Y Acad Sci,1958,68:1128-1132.
[2]Mc Elwain TJ,Powles RL.High-dose intravenous melphalan for plasma-cell leukaemia and myeloma[J].Lancet,1983,2:822-824.
[3]Singhal S,Mehta J,Desikan R,et al.Antitumor activity of thalidomide in refractory multiple myeloma[J].N Engl JMed,1999,341:1565-1571.
[4]Orlowski RZ,Eswara JR,Lafond-Walker A,et al.Tumor growth inhibition induced in a murine model of human Burkitt's lymphoma by a proteasome inhibitor[J].Cancer Res,1998,58:4342-4348.
[5]Orlowski RZ,Stinchcombe TE,Mitchell BS,et al.Phase Itrial of the proteasome inhibitor PS-341 in patients with refractory hematologic malignancies[J].J Clin Oncol,2002,20:4420-4427.
[6]Hideshima T,Richardson P,Chauhan D,et al.The proteasome inhibitor PS-341 inhibits growth,induces apoptosis,and overcomes drug resistance in human multiple myeloma cells[J].Cancer Res,2001,61:3071-3076.
[7]Kumar SK,Callander NS,Alsina M,et al.Multiple myeloma,version 3.2017,NCCN clinical practice guidelines in oncology[J].J Natl Compr Canc Netw,2017,15:230-269.
[8]Moreau P,San Miguel J,Sonneveld P,et al.Multiple myeloma:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2017,28:iv52-iv61.
[9]Chng WJ,Dispenzieri A,Chim CS,et al.IMWG consensus on risk stratification in multiple myeloma[J].Leukemia,2014,28:269-277.
[10]Dingli D,Ailawadhi S,Bergsagel PL,et al.Therapy for relapsed multiple myeloma:guidelines from the mayo stratification for myeloma and risk-adapted therapy[J].Mayo Clin Proc,2017,92:578-598.
[11]Barlogie B,Attal M,Crowley J,et al.Long-term follow-up of autotransplantation trials for multiple myeloma:update of protocols conducted by the intergroupe francophone du myelome,southwest oncology group,and university of arkansas for medical sciences[J].J Clin Oncol,2010,28:1209-1214.
[12]Porcher R,Lévy V,Fermand JP,et al.Evaluating high dose therapy in multiple myeloma:use of quality-adjusted survival analysis[J].Qual Life Res,2002,11:91-99.
[13]Facon T,Mary JY,Harousseau JL,et al.Front-line or rescue autologous bone marrow transplantation(ABMT)following a first course of high dose melphalan(HDM)in multiple myeloma(MM).Preliminary results of a prospective randomized trial(CIAM)protocol[J].Blood,1996,88:2729.
[14]Child JA,Morgan GJ,Davies FE,et al.High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma[J].N Engl J Med,2003,348:1875-1883.
[15]Barlogie B,Kyle RA,Anderson KC,et al.Standard chemotherapy compared with high-dose chemoradiotherapy for multiple myeloma:final results of phase III US intergroup trial S9321[J].J J Clin Oncol,2006,24:929-936.
[16]Rosi1ol L,Pérez-Simón JA,Sureda A,et al.A prospective PETHEMA study of tandem autologous transplantation versus autograft followed by reduced-intensity conditioning allogeneic transplantation in newly diagnosed multiple myeloma[J].Blood,2008,112:3591-3593.
[17]Lokhorst HM,Segeren CM,Verdonck LF,et al.Partially T-cell-depleted allogeneic stem-cell transplantation for first-line treatment of multiple myeloma:a prospective evaluation of patients treated in the phase III study HOVON 24 MM[J].JClin Oncol,2003,21:1728-1733.
[18]Palumbo A,Bringhen S,Petrucci MT,et al.Intermediatedose melphalan improves survival of myeloma patients aged 50to 70:results of a randomized controlled trial[J].Blood,2004,104:3052-3057.
[19]Facon T,Mary JY,Hulin C,et al.Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma(IFM 99-06):a randomised trial[J].Lancet,2007,370:1209-1218.
[20]Koreth J,Cutler CS,Djulbegovic B,et al.High-dose therapy with single autologous transplantation versus chemotherapy for newly diagnosed multiple myeloma:a systematic review and meta-analysis of randomized controlled trials[J].Biol Blood Marrow Transplant,2007,13:183-196.
[21]Etto LY,Morelli VM,Silva VC,et al.Autologous stem cell transplantation improves quality of life in economically challenged,Brazilian multiple myeloma patients[J].Clinics(Sao Paulo),2011,66:1855-1859.
[22]Attal M,Lauwers-Cances V,Hulin C,et al.Lenalidomide,bortezomib,and dexamethasone with transplantation for myeloma[J].N Engl J Med,2017,376:1311-1320.
[23]Keats JJ,Chesi M,Egan JB,et al.Clonal competition with alternating dominance in multiple myeloma[J].Blood,2012,120:1067-1076.
[2]Mc Elwain TJ,Powles RL.High-dose intravenous melphalan for plasma-cell leukaemia and myeloma[J].Lancet,1983,2:822-824.
[3]Singhal S,Mehta J,Desikan R,et al.Antitumor activity of thalidomide in refractory multiple myeloma[J].N Engl JMed,1999,341:1565-1571.
[4]Orlowski RZ,Eswara JR,Lafond-Walker A,et al.Tumor growth inhibition induced in a murine model of human Burkitt's lymphoma by a proteasome inhibitor[J].Cancer Res,1998,58:4342-4348.
[5]Orlowski RZ,Stinchcombe TE,Mitchell BS,et al.Phase Itrial of the proteasome inhibitor PS-341 in patients with refractory hematologic malignancies[J].J Clin Oncol,2002,20:4420-4427.
[6]Hideshima T,Richardson P,Chauhan D,et al.The proteasome inhibitor PS-341 inhibits growth,induces apoptosis,and overcomes drug resistance in human multiple myeloma cells[J].Cancer Res,2001,61:3071-3076.
[7]Kumar SK,Callander NS,Alsina M,et al.Multiple myeloma,version 3.2017,NCCN clinical practice guidelines in oncology[J].J Natl Compr Canc Netw,2017,15:230-269.
[8]Moreau P,San Miguel J,Sonneveld P,et al.Multiple myeloma:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2017,28:iv52-iv61.
[9]Chng WJ,Dispenzieri A,Chim CS,et al.IMWG consensus on risk stratification in multiple myeloma[J].Leukemia,2014,28:269-277.
[10]Dingli D,Ailawadhi S,Bergsagel PL,et al.Therapy for relapsed multiple myeloma:guidelines from the mayo stratification for myeloma and risk-adapted therapy[J].Mayo Clin Proc,2017,92:578-598.
[11]Barlogie B,Attal M,Crowley J,et al.Long-term follow-up of autotransplantation trials for multiple myeloma:update of protocols conducted by the intergroupe francophone du myelome,southwest oncology group,and university of arkansas for medical sciences[J].J Clin Oncol,2010,28:1209-1214.
[12]Porcher R,Lévy V,Fermand JP,et al.Evaluating high dose therapy in multiple myeloma:use of quality-adjusted survival analysis[J].Qual Life Res,2002,11:91-99.
[13]Facon T,Mary JY,Harousseau JL,et al.Front-line or rescue autologous bone marrow transplantation(ABMT)following a first course of high dose melphalan(HDM)in multiple myeloma(MM).Preliminary results of a prospective randomized trial(CIAM)protocol[J].Blood,1996,88:2729.
[14]Child JA,Morgan GJ,Davies FE,et al.High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma[J].N Engl J Med,2003,348:1875-1883.
[15]Barlogie B,Kyle RA,Anderson KC,et al.Standard chemotherapy compared with high-dose chemoradiotherapy for multiple myeloma:final results of phase III US intergroup trial S9321[J].J J Clin Oncol,2006,24:929-936.
[16]Rosi1ol L,Pérez-Simón JA,Sureda A,et al.A prospective PETHEMA study of tandem autologous transplantation versus autograft followed by reduced-intensity conditioning allogeneic transplantation in newly diagnosed multiple myeloma[J].Blood,2008,112:3591-3593.
[17]Lokhorst HM,Segeren CM,Verdonck LF,et al.Partially T-cell-depleted allogeneic stem-cell transplantation for first-line treatment of multiple myeloma:a prospective evaluation of patients treated in the phase III study HOVON 24 MM[J].JClin Oncol,2003,21:1728-1733.
[18]Palumbo A,Bringhen S,Petrucci MT,et al.Intermediatedose melphalan improves survival of myeloma patients aged 50to 70:results of a randomized controlled trial[J].Blood,2004,104:3052-3057.
[19]Facon T,Mary JY,Hulin C,et al.Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma(IFM 99-06):a randomised trial[J].Lancet,2007,370:1209-1218.
[20]Koreth J,Cutler CS,Djulbegovic B,et al.High-dose therapy with single autologous transplantation versus chemotherapy for newly diagnosed multiple myeloma:a systematic review and meta-analysis of randomized controlled trials[J].Biol Blood Marrow Transplant,2007,13:183-196.
[21]Etto LY,Morelli VM,Silva VC,et al.Autologous stem cell transplantation improves quality of life in economically challenged,Brazilian multiple myeloma patients[J].Clinics(Sao Paulo),2011,66:1855-1859.
[22]Attal M,Lauwers-Cances V,Hulin C,et al.Lenalidomide,bortezomib,and dexamethasone with transplantation for myeloma[J].N Engl J Med,2017,376:1311-1320.
[23]Keats JJ,Chesi M,Egan JB,et al.Clonal competition with alternating dominance in multiple myeloma[J].Blood,2012,120:1067-1076.