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目的探讨-80℃低温保存自体外周血干细胞移植(APBSCT)治疗多发性骨髓瘤(MM)的有效性和安全性。方法对10例MM患者进行APBSCT治疗。采用环磷酰胺(CTX)+粒细胞集落刺激因子(G-CSF)方案动员干细胞,CS-3000血细胞分离机采集外周血干细胞并保存于-80℃冰箱;用马法兰200 mg/m2方案预处理后,解冻回输冻存的干细胞。结果 (1)动员后获得单个核细胞数(MNC)中位数为4.54(2.31~9.80)×108/kg;CD34+细胞数中位数为4.17(2.03~7.76)×106/kg。(2)移植后10例患者均获得造血重建,中性粒细胞计数>0.5×109/L、血小板计数>20×109/L的中位时间分别是13.3(9~16)d、15(11~19)d。(3)移植后3个月完全缓解(CR)8例,非常好的部分缓解(VGPR)2例。中位随访54.6(3~111)月,生存8例(CR5例,VGPR 3例),其中无进展生存6例。复发4例中再次治疗维持CR 2例,多次复发死亡2例。(4)移植的并发症是感染,无移植相关死亡。结论 -80℃低温保存APBSCT治疗MM安全有效,近期疗效好,移植后需要长期维持治疗。
Objective To investigate the efficacy and safety of cryopreserved autologous peripheral blood stem cell transplantation (APBSCT) at -80 ℃ in the treatment of multiple myeloma (MM). Methods Ten patients with MM were treated with APBSCT. Stem cells were mobilized by CTX + G-CSF and peripheral blood stem cells were collected by CS-3000 blood cell separator and stored at -80 ℃. After pretreatment with melphalan 200 mg / m2 , Thawed back the frozen stem cells. Results (1) The median number of mononuclear cells (MNC) was 4.54 (2.31-9.80) × 108 / kg after mobilization, and the median number of CD34 + cells was 4.17 (2.03-7.76) × 106 / kg. (2) The median time of hematopoietic reconstitution, neutrophil count> 0.5 × 109 / L and platelet count> 20 × 109 / L were all 13.3 (9-16) d and 15 ~ 19) d. (3) 8 cases were completely relieved (CR) 3 months after transplantation, and 2 cases had very good partial response (VGPR). The median follow-up 54.6 (3 ~ 111) months, 8 patients survived (CR5 cases, VGPR 3 cases), of which 6 cases of progression-free survival. Recurrence in 4 cases re-treatment to maintain CR 2 cases, multiple recurrence of death in 2 cases. (4) The complications of transplantation were infection without transplantation-related death. Conclusion: APBSCT at -80 ℃ is safe and effective in the treatment of MM with short-term curative effect. Long-term maintenance therapy is needed after transplantation.