异基因造血干细胞移植治疗多发性骨髓瘤

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The graft does not contain tumor cells and the potential for a graft versus myeloma (GvM) effect
异基因造血干细胞移植治疗多发性 骨髓瘤
Bone marrow transplantation in three patients with multiple myeloma
Allogeneic haematopoietic cell transplantation for multiple myeloma
异基因造血干细胞移植治疗多发性 骨髓瘤
The allogeneic transplant has the advantage over the autologous transplant
A third patient with IgG-lambda myeloma died of effusive pericarditis shortly after transplantation.
Acta Med Scan异d基因1造98血6干;2骨细1髓胞9(瘤移5)植:5治2疗3-多7发性
A second patient with Bence-Jones kappa myeloma is well, and skeletal pain and BenceJones proteinuria has disappeared 2 months after transplantation.
Melphalan containing regimes tended to be morely used in group 3
Melphalan or Busulphan + CY rarely
异基因造血干细胞移植治疗多发性 骨髓瘤
Engraftment
异基因造血干细胞移植治疗多发性 骨髓瘤
ห้องสมุดไป่ตู้
GVHD
With no significantly difference between group 2 and 3
异基因造血干细胞移植治疗多发性 骨髓瘤
Cause of death
75% in group 1,36% in group 2 ,33 % in group 3
GVHD Fungal ARDS Organ failure
356 during 1994-98 (223 with BM group 2 and 133 with PB group 3)
异基因造血干细胞移植治疗多发性 骨髓瘤
异基因造血干细胞移植治疗多发性 骨髓瘤
the median age at transplantation of patients in
Gahrton G, Ringdén O, Lönnqvist B, Lindquist R, Ljungman P.
Myeloablative conditioning
瑞典卡罗林斯卡医学院 1983
Acta Med Scand 1986;219(5异):基5因23造-7血.干骨细髓胞瘤移植治疗多发性
异基因造血干细胞移植治疗多发性 骨髓瘤
Out of 690 allogenetic matched sibling
donor transplants for MM
344 were performed during the period 198393(all with BM ) [group 1]
Three patients with multiple myeloma received bone marrow grafts from HLA-identical sibling donors
One of the patients, with IgA kappa myeloma, refractory to alkeran-prednisone therapy, is well and still without sign of disease 26 months post transplantation
group 1 was 43 years (range 21-62) In group 2 ,44 years (range 18_57) and in group
3, 46 years (range 25_60)
异基因造血干细胞移植治疗多发性 骨髓瘤
Conditiong regime
TBI+CY tended to be more commonly used in group 1(37%) and 2 (39%) than in group 3 (27%)
异基因造血干细胞移植治疗多发性 骨髓瘤
Cause of death
the study shows that the improvement is entirely a result of a lower TRM during the latest 5-years period
Conclusion
Bone marrow transplantation may be indicated in a selective group of patients with multiple myeloma
异基因造血干细胞移植治疗多发性
Acta Med Scand 1骨98髓6瘤;219(5):523-7
异基因造血干细胞移植治疗多发性 骨髓瘤
Treatment –related mortality
异基因造血干细胞移植治疗多发性 骨髓瘤
Treatment –related mortality
异基因造血干细胞移植治疗多发性 骨髓瘤
Relapse rate
异基因造血干细胞移植治疗多发性 骨髓瘤
Relapse rate
异基因造血干细胞移植治疗多发性 骨髓瘤
Survival
异基因造血干细胞移植治疗多发性 骨髓瘤
Survival
异基因造血干细胞移植治疗多发性 骨髓瘤
Progression –free survival
PFS was significantly better for group 2than
for group 1(P<0.0001)
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