自体造血干细胞移植治疗伴肾功能不全的多发性骨髓瘤

Autologous hematopoietic stem cell transplantation for treatment of multiple myeloma patients with renal impairment

多发性骨髓瘤(MM)作为血液科的三大肿瘤性疾病之一,诊断时近半数患者合并肾功能不全,且合并重度肾功能不全患者比例高达15%~20%。轻中度肾功能不全MM患者的自体造血干细胞移植(AHCT)预处理方案首选美法仑200 mg/m2为主方案(Mel 200方案),而重度肾功能不全患者的预处理方案宜选美法仑400 mg/m2为主方案(Mel 140方案)。AHCT是初治MM的一线治疗手段,其应用于伴有肾功能不全的MM患者,能进一步提高反应深度,修复肾脏损伤,改善生存状况。AHCT是治疗合并肾功能损伤MM的安全、有效措施。

Multiple myeloma (MM) is a common hematological malignancy with renal impairment in approximately 50% of patients. Sever renal impairment occurs in 15%-20% of newly diagnosed multiple myeloma patients. 200 mg/m2 melphalan-based regimen (Mel 200 regimen) as conditioning regimen of autologous hematopoietic stem cell transplantation (AHCT) is suitable for multiple myeloma patients with mild or moderate renal impairment, and 400 mg/m2 melphalan-based regimen (Mel 140 regimen) is fit for multiple myeloma patients with severe renal impairment. As the first line therapy for multiple myeloma patients with renal impairment, AHCT can increase response depth, repair renal function and improve survival. AHCT is a safe and beneficial procedure for MM patients with renal failure.