自休造血千细胞移植治疗多发性骨髓瘤的疗效评价 及影响因素:单中心真实卅界研

Objective To evaluate the clinical efficacy and prognostic factors in multiple myeloma (MM) patients treated with autologous hematopoietic stem cell transplantation (auto-HSCT).Methods The clinical data of 155 MM patients newly diagnosed and suitable for transplantation in our hospital from 2014 to 2021 were retrospectively analyzed.They were divided into auto-HSCT group and non-auto-HSCT group according to the treatment mode.The clinical efficacy，overall survival (OS) and progression-free survival (PFS) of the two groups were compared.Furthermore，the prognostic factors of auto-HSCT group were analyzed.Results ① There were 51 patients in auto-HSCT group and 104 patients in non-auto-HSCT group.There was no statistical difference in baseline characteristics except age between the two groups.② Hematopoietic reconstruction was achieved in all patients in auto-HSCT group, and no transplantation-related mortality was found.③ The clinical efficacy of pre-and post-transplantation was compared in auto-HSCT group.sCR/CR rate was significantly increased after transplantation (P= 0.041).The effective remission rate >VGPR) was also higher (P= 0.05).As for the best efficacy，sCR/CR rate and effective remission rate were both significantly higher in auto-HSCT group than in non-auto-HSCT group (P= 0.001).④ In auto-HSCT group, by the end of follow-up, the median OS was not reached, the median PFS was 30.5 months，and 3-year OS and PFS was 87% and 40.3%，respectively.In non-auto-HSCT group，the median OS was 61 months，the median PFS was 21 months，and 3-year OS and PFS was 65.3% and 33.1%，respectively.It indicated that OS was significantly prolonged in auto-HSCT group (P= 0.004).PFS was also prolonged but without significant difference (P= 0.065).⑤ Analysis of prognostic factors in auto-HSCT group showed that decreased PLT (P= 0.038) and increased serum-adjusted calcium (P=0.017) were independent risk factors for OS，decreased PLT (P= 0.005)，female (P = 0.018) and disease status of PR or worse before transplantation ( P = 0.012) were independent risk factors for PFS.Conclusion Auto-HSCT can improve the remission rate，prolong OS in MM patients，and possibly prolong PFS.Increased serum-corrected calcium and decreased PLT are independent prognostic factors for OS in patients treated with auto-HSCT.Decreased PLT, female，and disease status of PR or worse before transplantation are independent prognostic factors for PFS.