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Modified conditioning regimen busulfan-cyclophosphamide followed by allogeneic stem cell transplantation in patients with multiple myeloma
Zhang Xiao-hui; Huang Xiao-jun; Liu Kai-yan; Xu Lan-ping; Liu Dai-hong; Chen Huan; Chen Yu-hong; Wang Jing-zhi; Han Wei; Lu Dao-pei
关键词Multiple Myeloma Stem Cell Transplantation Modified Conditioning Regimen
刊名CHINESE MEDICAL JOURNAL
2007-03-20
120期:6页:463-468
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]BONE-MARROW TRANSPLANTATION ; SINGLE-CENTER EXPERIENCE ; RANDOMIZED TRIAL ; DENDRITIC CELLS ; THALIDOMIDE ; THERAPY ; CHIMERISM ; MORTALITY ; SURVIVAL
英文摘要

Background Allogeneic stem cell transplantation is a potential curative approach in patients with multiple myeloma. The very high transplant related mortality associated with standard allogeneic stem cell transplantation is currently the major limitation to wider use of this potentially curative treatment modality. The challenge for clinical investigators is to reduce the incidence of post-transplant complications for. patients receiving autologous hematopoietic stem cell transplantion for multiple myeloma. In this study the toxicity and efficacy of modified myeloablative conditioning regimen followed by allogeneic stem cell transplantation was investigated in patients with multiple myeloma.

Methods The conditioning regimen consisted of hydroxyurea, cytarabine, busulfan, cyclophosphamide, and semustine. Ten patients underwent allogeneic transplantation among them hydroxyurea (40 mg/kg) was administered twice on day -10 and cytarabine (2 g/m(2)) was given on day -9, busulfan was administered orally in four divided doses daily for 3 days (days -8 to -6). The dose of busulfan was 12 mg/kg in the protocol followed by cyclophosphamide intravenously over 1 hour on days -5 and -4 (1.8 g/m(2)), and with semustine (Me-CCNU) 250 mg/m(2) on day -3.

Results Chimerism data were available on all patients and all patients achieved full donor chimerism without graft failure. Six patients had not acute graft-versus-host disease (GVHD, 36.4%; 95% Ck 13.9%-38.6%). Two patients (18.2%) developed grade I acute GVHD (95% Cl: 10.9%-35.9%) and grade II acute GVHD occurred in one patient (9.1 %; 95% Cl: 8.4%-32.3%). Severe grade IVa GVHD was seen in one patient, who died from acute GVHD. The incidence of chronic GVHD was 22.2% (95% Cl. 11.7%-36.7%), among them one died of severe grade IV GVHD and one developed multiorgan failure on day +170; the treatment-related mortality was 22.0% (95% Cl: 10.3%-34.1 %). The overall 4-year survival rate was 67.8% (95% Cl: 16.3%-46.7%). The estimated 4-year progression-free survival rate was 58.5% (95% Cl: 13.7%-41.8%). The 4-year complete remission was 72.7% (95% Cl: 27.8%-49.6%). One patient relapsed after 4 months and achived the complete remission after receiving the donor lymphocyte infusion.

Conclusions Modified conditioning regimen busulfan-cyclophosphamide with peripheral blood stem cells+bone marrow cells transplantation result in a low incidence of severe GVHD with a relatively low treatment-related mortality, high complete remission rates and a long-term survival.

语种英语
WOS记录号WOS:000245453400005
引用统计
被引频次:5[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55045
专题北京大学第二临床医学院_血液科
作者单位Peking Univ, Peoples Hosp, Inst Hematol, Beijing 100044, Peoples R China
推荐引用方式
GB/T 7714
Zhang Xiao-hui,Huang Xiao-jun,Liu Kai-yan,et al. Modified conditioning regimen busulfan-cyclophosphamide followed by allogeneic stem cell transplantation in patients with multiple myeloma[J]. CHINESE MEDICAL JOURNAL,2007,120(6):463-468.
APA Zhang Xiao-hui.,Huang Xiao-jun.,Liu Kai-yan.,Xu Lan-ping.,Liu Dai-hong.,...&Lu Dao-pei.(2007).Modified conditioning regimen busulfan-cyclophosphamide followed by allogeneic stem cell transplantation in patients with multiple myeloma.CHINESE MEDICAL JOURNAL,120(6),463-468.
MLA Zhang Xiao-hui,et al."Modified conditioning regimen busulfan-cyclophosphamide followed by allogeneic stem cell transplantation in patients with multiple myeloma".CHINESE MEDICAL JOURNAL 120.6(2007):463-468.
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