自体造血干细胞移植治疗多发性骨髓瘤预处理方案的研究进展

Progress in preconditioning regimen of autologous hematopoietic stem cell transplantation for treatment of multiple myeloma

大剂量美法仑（Mel）是多发性骨髓瘤（MM）疗效最肯定的预处理方案.全身放疗（TBI）联合Mel的疗效不优于单用Mel,但不良反应增加.在年轻患者中Mel 200 mg/m^2疗效优于Mel 100~140 mg/m^2.MelBU、TBC、BCV、MET、MTC、MelBCNU、VMel、MTC以及含有苯达莫司汀的预处理方案可获得同大剂量Mel类似的治疗效果.新预处理方案的效果需要更多临床试验证实.

High-dose melphalan （Mel） is considered as a current standard preparative regimen in autologous stem cell transplantation （ASCT） for multiple myeloma （MM）. Irradiation in total body （TBI） combined with Mel is not superior to Mel alone, and the adverse reactions are increased at the same time. The efficacy of 200 mg/m^2 Mel is much better than that of 100-140 mg/m^2 Mel in young patients. Several regimens including MelBU, TBC, BCV, MET, MTC, MelBCNU, VMel, MTC as well as bendamustine have similar treatment outcomes compared with 200 mg/m2 Mel. Other strategies need to be evaluated in different trials.