PROGNOSTIC FACTORS IN AUTOLOGOUS STEM-CELL TRANSPLANTATION FOR MULTIPLE-MYELOMA - AN EBMT REGISTRY STUDY

被引：64

作者：

BJORKSTRAND, B

GOLDSTONE, AH

LJUNGMAN, P

BRANDT, L

BRUNET, S

CARLSON, K

PRENTICE, HG

CAVO, M

SAMSON, D

DELAURENZI, A

VERDONCK, LF

PROCTOR, S

FERRANT, A

SIERRA, J

AUZANNEAU, G

TROUSSARD, X

GRAVETT, P

REMES, K

GAHRTON, G

机构：

[1] Department of Medicine, Huddinge Hospital and Karolinska Institute, Huddinge

[2] Department of Haematology, University College and Middlesex School of Medicine, London

[3] Department of Hematology, Hospital Santa Creu i Sant Pau, Barcelona

[4] Department of Medicine, University Hospital, Uppsala

[5] Department of Haematology, Royal Free Hospital, London

[6] Department of Hematology, Hospital San Orsola, Bologna

[7] Department of Haematology, Charing Cross Hospital, London

[8] Department of Hematology, Hospital San Camillo, Rome

[9] Department of Hematology, University Hospital, Utrecht

[10] Department of Hematology, Royal Victoria Infirmary, Newcastle

[11] Department of Haematology, Cliniques Universitaires St. Luc, Brussels

[12] School of Hematology, Clinical Hospital, Barcelona

[13] Hematology Clinic, Hôpital destruction des Armées du Val-de-Gråce, Paris

[14] Hematology Service, Hospital Caen, Caen

[15] The London Clinic, London Oncology and BMT Group, London

[16] Department of Medicine, University Central Hospital, Turku

来源：

LEUKEMIA & LYMPHOMA | 1994年 / 15卷 / 3-4期

关键词：

MULTIPLE MYELOMA; AUTOLOGOUS STEM CELL TRANSPLANTATION; PROGNOSTIC FACTORS; REGISTRY STUDY;

D O I：

10.3109/10428199409049723

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Autologous bone marrow- and blood progenitor cell transplantation was performed in 130 patients with multiple myeloma in 16 European centers between 1986 and 1993. At the time of follow-up, 77 patients were alive and 53 were dead. Complete remission after transplantation was obtained in 47% of all patients. The actuarial survival at 65 months was 28%. The median duration of relapse-free survival among patients who were in complete remission after transplantation was 29 months. The following factors were predictive for longer survival and freedom of progression in a univariate analysis: Male sex, age less than 45 years, a low serum-beta-2-microglobulin value at diagnosis, prior administration of only one treatment regimen, response on conventional chemotherapy immediately pretransplant and the use of a preparative regimen including melphalan. The last factor, in addition to stage I disease at diagnosis, male sex and responsive disease immediately pretransplant, were also demonstrated as independent predictive variables for longer survival in a multivariate analysis. Progression-free survival was significantly better for patients who were in complete remission after transplantation, as compared to those with persisting signs of disease. We conclude that high-dose chemo-radiotherapy with autologous stem cell transplantation can induce long-term responses, primarily in younger, male patients with chemotherapy-responsive early disease. High-dose melphalan, as single drug or in combination, appeared to be superior to other regimens. The chance of being persistently disease-free seemed to be greatest for patients being in complete remission already before the transplantation.

引用

页码：265 / 272

页数：8

共 20 条

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