摘要
Background Autologous stem cell transplantation （ASCT） is a part of the standard induction therapy of multiple myeloma （MM）. This case-controlled clinical trial aimed to further evaluate the therapeutic effects of ASCT as a consolidation therapy for MM and discuss factors influencing the prognosis.Methods Clinical data of 70 patients diagnosed as MM who received ASCT as a consolidation therapy in our hospital between October 1998 and August 2010 were analyzed retrospectively （ASCT group）. Other 70 MM patients receiving routine chemotherapy without ASCT （non-ASCT group） during the same period were used as controls. Differences in the degree and duration of remission, progression-free survival （PFS） and overall survival （OS） were compared to explore factors that may influence the prognosis.Results The median follow-up period was 38 months （range 1-128 months）. The complete response （CR） rate of ASCT group increased from 27.1% （19/70） before ASCT to 51.4% （36/70） after ASCT. The median PFS of ASCT group was significantly higher than non-ASCT group （45 months vs. 25 months, P 〈0.001）. The median OS of ASCT group was also significantly higher （55 months vs. 30 months, P=0.016）. Single-factor analysis showed that International Staging System （ISS） stage, very good partial response （VGPR） or better outcome were significantly correlated with PFS and OS （P 〈0.001）. Multi-factor analysis showed that whether or not VGPR or better outcome was achieved were independent factors influencing the disease prognosis.Conclusion Used as a consolidation therapy, ASCT can achieve better responses and higher OS and PFS of MM patients.
Background Autologous stem cell transplantation （ASCT） is a part of the standard induction therapy of multiple myeloma （MM）. This case-controlled clinical trial aimed to further evaluate the therapeutic effects of ASCT as a consolidation therapy for MM and discuss factors influencing the prognosis.Methods Clinical data of 70 patients diagnosed as MM who received ASCT as a consolidation therapy in our hospital between October 1998 and August 2010 were analyzed retrospectively （ASCT group）. Other 70 MM patients receiving routine chemotherapy without ASCT （non-ASCT group） during the same period were used as controls. Differences in the degree and duration of remission, progression-free survival （PFS） and overall survival （OS） were compared to explore factors that may influence the prognosis.Results The median follow-up period was 38 months （range 1-128 months）. The complete response （CR） rate of ASCT group increased from 27.1% （19/70） before ASCT to 51.4% （36/70） after ASCT. The median PFS of ASCT group was significantly higher than non-ASCT group （45 months vs. 25 months, P 〈0.001）. The median OS of ASCT group was also significantly higher （55 months vs. 30 months, P=0.016）. Single-factor analysis showed that International Staging System （ISS） stage, very good partial response （VGPR） or better outcome were significantly correlated with PFS and OS （P 〈0.001）. Multi-factor analysis showed that whether or not VGPR or better outcome was achieved were independent factors influencing the disease prognosis.Conclusion Used as a consolidation therapy, ASCT can achieve better responses and higher OS and PFS of MM patients.
基金
The study was partly supported by the National Natural Science Foundation of China （No. 81001050） and the Health Ministry Foundation for Clinical Sciences Development （Project 2010-2012）.Acknowledgements： We thank Prof. CAO Yang （Department of Statistics, the Second Military Medical University） for the statistical work.
