医学-异基因造血干细胞移植治疗多发性骨髓瘤
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
瑞典卡罗林斯卡医学院 1983
Acta Med Scand 1986;219(5):523-7.
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
A third patient with IgG-lambda myeloma died of effusive pericarditis shortly after transplantation.
Acta Med Scand 1986;219(5):523-7
Conclusion
Bone marrow transplantation may be indicated in a selective group of patients with multiple myeloma
A second patient with Bence-Jones kappa myeloma is well, and skeletal pain and BenceJones proteinuria has disappeared 2 months after transplantation.
aGVHD has no changed during this peroid
There was significant difference in deaths caused by IP and bacterial and fungalinfection
Conditioning regime
Bone marrow transplantation in three patients with multiple myeloma
Gahrton G, Ringdén O, Lönnqvist B, Lindquist R, Ljungman P.
Myeloablative conditio来自百度文库ing
Acta Med Scand 1986;219(5):523-7
Out of 690 allogenetic matched sibling
donor transplants for MM
344 were performed during the period 198393(all with BM ) [group 1]
In group 2 ,44 years (range 18_57) and in group 3, 46 years (range 25_60)
Conditiong regime
TBI+CY tended to be more commonly used in group 1(37%) and 2 (39%) than in group 3 (27%)
TBI+Melphalan has not previrous been Shown to be superior to TBI+CY in this
study
conclusion
Survival 30~60% Treatment –related mortality 30%
Myeloablative allogeneic versus autologous transplantation
Allogeneic haematopoietic cell transplantation for multiple myeloma
The allogeneic transplant has the advantage over the autologous transplant
The graft does not contain tumor cells and the potential for a graft versus myeloma (GvM) effect
Relapse rate
Relapse rate
Survival
Survival
Progression –free survival
PFS was significantly better for group 2than
for group 1(P＜0.0001)
With no significantly difference between group 2 and 3
356 during 1994-98 (223 with BM group 2 and 133 with PB group 3)
the median age at transplantation of patients in
group 1 was 43 years (range 21-62)
Cause of death
75% in group 1,36% in group 2 ,33 % in group 3
GVHD Fungal ARDS Organ failure
Cause of death
the study shows that the improvement is entirely a result of a lower TRM during the latest 5-years period
Melphalan containing regimes tended to be morely used in group 3
Melphalan or Busulphan + CY rarely
Engraftment
GVHD
Treatment –related mortality
Treatment –related mortality
Acta Med Scand 1986;219(5):523-7.
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
A third patient with IgG-lambda myeloma died of effusive pericarditis shortly after transplantation.
Acta Med Scand 1986;219(5):523-7
Conclusion
Bone marrow transplantation may be indicated in a selective group of patients with multiple myeloma
A second patient with Bence-Jones kappa myeloma is well, and skeletal pain and BenceJones proteinuria has disappeared 2 months after transplantation.
aGVHD has no changed during this peroid
There was significant difference in deaths caused by IP and bacterial and fungalinfection
Conditioning regime
Bone marrow transplantation in three patients with multiple myeloma
Gahrton G, Ringdén O, Lönnqvist B, Lindquist R, Ljungman P.
Myeloablative conditio来自百度文库ing
Acta Med Scand 1986;219(5):523-7
Out of 690 allogenetic matched sibling
donor transplants for MM
344 were performed during the period 198393(all with BM ) [group 1]
In group 2 ,44 years (range 18_57) and in group 3, 46 years (range 25_60)
Conditiong regime
TBI+CY tended to be more commonly used in group 1(37%) and 2 (39%) than in group 3 (27%)
TBI+Melphalan has not previrous been Shown to be superior to TBI+CY in this
study
conclusion
Survival 30~60% Treatment –related mortality 30%
Myeloablative allogeneic versus autologous transplantation
Allogeneic haematopoietic cell transplantation for multiple myeloma
The allogeneic transplant has the advantage over the autologous transplant
The graft does not contain tumor cells and the potential for a graft versus myeloma (GvM) effect
Relapse rate
Relapse rate
Survival
Survival
Progression –free survival
PFS was significantly better for group 2than
for group 1(P＜0.0001)
With no significantly difference between group 2 and 3
356 during 1994-98 (223 with BM group 2 and 133 with PB group 3)
the median age at transplantation of patients in
group 1 was 43 years (range 21-62)
Cause of death
75% in group 1,36% in group 2 ,33 % in group 3
GVHD Fungal ARDS Organ failure
Cause of death
the study shows that the improvement is entirely a result of a lower TRM during the latest 5-years period
Melphalan containing regimes tended to be morely used in group 3
Melphalan or Busulphan + CY rarely
Engraftment
GVHD
Treatment –related mortality
Treatment –related mortality