自体造血干细胞移植治疗初治多发性骨髓瘤的临床分析

OBJECTIVE: To evaluate the effect of autologous stem cell transplantation（auto-HSCT）on treatment remission and survival of newly diagnosed multiple myeloma（MM）patients. METHODS: A total of 243 new diagnosed MM patients（age ≤65 years）who had received auto-HSCT were selected, and 176 MM patients（age ≤65 years）who had not received auto-HSCT were selected as the control group to evaluate the effect of auto-HSCT on the remission and survival. To balance the distribution of prognostic factors between auto-HSCT and non-auto-HSCT patients, the propensity score matching technique was used to reduce the bias between groups in a 1∶1 scale, 64 in each group, and correlation analysis was performed. RESULTS: A total of 128 patients（64 cases in each group）were screened by propensity score matching analysis. 64 patients received auto-HSCT after induction therapy. After auto-HSCT, 24 patients （37.5％）obtained sCR, 16 patients（25.0％）obtained CR, 15 patients（23.4％）obtained VGPR, and 9 patients（14.1％）obtained PR. The efficacy of patients with auto-HSCT was significantly better than that of non-auto-HSCT patients（P＝0.032）. Progression-free survival（PFS）and overall survival（OS）were significantly longer in auto-HSCT patients compared with non-auto-HSCT patients［PFS: 42.2（95％ CI 29.9–54.5）months vs 22.4（95％ CI 17.1–27.7）months, P＝0.007; OS: 87.6（95％ CI 57.3–117.9） months vs 53.9（95％ CI 36.1–71.7）months, P＝0.011］. Multivariate analysis confirmed that auto-HSCT had a favorable effect on OS（HR＝0.448, 95％CI 0.260–0.771, P＝0.004）and PFS（HR＝0.446, 95％CI 0.280–0.778, P＝0.003）. CONCLUSION: These results demonstrated that auto-HSCT was a favorable prognostic factor for newly diagnosed MM patients.