Autologous stem cell transplantation in myeloma: the St James’s Hospital experience, 1997–2003

BackgroundHigh-dose treatment with autologous stem cell transplantation (ASCT) has become the standard of care for patients with myeloma below the age of 65 years.AimsWe report an audit of 60 patients (median age: 52.5 years) who underwent ASCT in the National Bone Marrow Transplant centre in St James’s Hospital in Dublin between 1997 and 2003 inclusive.MethodsClinical and laboratory data were retrieved from patient medical records and hospital information management systems.ResultsThirty-six patients had IgG, 11 IgA, 1 IgD, 9 light chain and 3 non-secretory MM. Fifty-seven (95%) patients received anthracycline-corticosteroid combination chemotherapy prior to autografting. There was no transplant-related mortality (TRM). Complete (CR) and Partial Responses (PR) were seen in 16 (29.6%) and 29 (53.7%) of those evaluable (n = 54 (90%)). The actuarial Progression-Free (PFS) and Overall Survival (OS) rates at five years are 13% and 55% respectively.ConclusionCentre outcome is comparable to published international series and supports the use of ASCT in the treatment of this malignancy.

背景 大剂量自体干细胞移植（ASCT）治疗已成为65岁以下骨髓瘤患者的标准治疗方法。 目的 我们报告了对1997年至2003年期间在都柏林圣詹姆斯医院国家骨髓移植中心接受ASCT的60例患者（中位年龄：52.5岁）的审核情况。 方法 从患者病历和医院信息管理系统中获取临床和实验室数据。 结果 36例患者为IgG型，11例为IgA型，1例为IgD型，9例为轻链型，3例为非分泌型骨髓瘤。57例（95%）患者在自体移植前接受了蒽环类 - 糖皮质激素联合化疗。无移植相关死亡（TRM）。在可评估的患者（n = 54例，90%）中，完全缓解（CR）和部分缓解（PR）分别为16例（29.6%）和29例（53.7%）。5年无进展生存率（PFS）和总生存率（OS）分别为13%和55%。 结论 该中心的治疗结果与已发表的国际系列研究相当，支持在这种恶性肿瘤的治疗中使用ASCT。