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Retrospective analysis of the efficacy and influencing factors of autologous hematopoietic stem cell transplantation for multiple myeloma
Author(s) -
Zhang BingLei,
Zhou Jian,
Lin QuanDe,
Liu YuZhang,
Zhang YanLi,
Gui RuiRui,
Song YongPing,
Fang BaiJun
Publication year - 2019
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.13468
Subject(s) - medicine , multiple myeloma , transplantation , hematopoietic stem cell transplantation , autologous stem cell transplantation , hematology , surgery , stage (stratigraphy) , proportional hazards model , retrospective cohort study , oncology , gastroenterology , paleontology , biology
This study aims to review the clinical efficacy and factors affecting the treatment of multiple myeloma (MM) by autologous hematopoietic stem cell transplantation (ASCT). The clinical data of 47 patients with MM from the Department of Hematology of Henan Cancer Hospital from September 2010 to July 2018 were retrospectively analyzed. At pre‐transplantation of autologous cells, 25.5% were in complete remission (CR), 14.9% were in very good partial remission (VGPR) and 59.6% were in partial remission (PR). Among these cases, one case had PR after three recurrences. At post‐transplantation, 51% were in CR, including two cases who received double transplantations, 27.7% were in VGPR, and 21.3% were in PR. The median follow‐up time was 27.6 months (4–96 months). The 3‐year progression free survival (PFS) and overall survival (OS) were 47.9% and 79.6%, respectively. The Analysis of variance (ANOVA) results revealed that factors that affected OS were international staging system (ISS) stage ( P = 0.002), CR and VGPR post‐transplantation ( P = 0.002), while factors that affected PFS were ISS stage ( P = 0.005), pre‐transplant induction therapy ( P = 0.032), and disease risk stratification ( P = 0.017). The curative effects for PFS were CR and VGPR pre‐transplantation ( P = 0.013) and post‐transplantation ( P = 0.011). The Cox multivariate regression analysis revealed that ISS stage and CR and VGPR post‐transplantation were independent prognostic factors of OS. At post‐transplantation, CR and VGPR, ISS stage, and pre‐transplant induction therapy were independent prognostic factors for PFS. In conclusion, ASCT can improve the clinical efficacy and survival rate of MM patients. ISS stage, CR and VGPR post‐transplantation are independent prognostic factors of OS and PFS, while pre‐transplant induction therapy is an independent prognostic factor for PFS.