Роль высокодозной химиотерапии с трансплантацией клеток-предшественников гемопоэза в лечении множественной миеломы
https://doi.org/10.17650/1818-8346-2008-0-4-11-16
Аннотация
В качестве терапии 2-й линии 18 больным с множественной миеломой была проведена терапия мелфаланом в дозе 200 мг/м2 с последующей трансплантацией аутологичных периферических стволовых клеток. 13 больным был проведен 1 курс высокодозной химиотерапии (ВДХТ), 5 — 2 курса. У всех пациентов до ВДХТ на фоне терапии была получена частичная ремиссия (у 15 больных ремиссия достигнута после проведения 3 курсов полихимиотерапии по схеме VAD— винкристин, доксорубицин, дексаметазон, у 3— после 3 курсов VAD и 2 курсов велкейддоксорубицин—преднизолон). Медиана времени до прогрессирования составила 33,1 (от 26 до 40) мес, общей выживаемости — 55,4 (от 29 до 40) мес.
Об авторах
С. В. МиненкоРоссия
Москва
А. Ю. Попов
Россия
Москва
Н. В. Жуков
Россия
Москва
О. М. Вотякова
Россия
Москва
В. В. Птушкин
Россия
Москва
Список литературы
1. Alexanian R., Haut A., Khan A.U. et al. Treatment for multiple myeloma: combination chemotherapy with different melphalan dose regimens. JAMA 1969;208:1680—5.
2. Myeloma Trialists’ Collaborative Group. Combination chemotherapy vs melphalan plus prednisone as treatment for multiple myeloma: an overview of 6633 patients from 27 randomized trials. J Clin Oncol 1998;16:3832—42.
3. Thomas E.D., Lochte H.L. Jr., Lu W.C., Ferrebee J.W. Intravenous infusion of bone marrow in patients receiving radiation and chemotherapy. N Engl J Med 1957;257:491—6.
4. Osserman E.F., DiRe L.B., DiRe J. et al. Identical twin marrow transplantation in multiple myeloma. Acta Haematol 1982;68:215—23.
5. Fefer A., Cheever M.A., Greenberg P.D. Identical twin (syngeneic) marrow transplantation for hematologic cancers. J Natl Cancer Inst 1986;76:1269—73.
6. Gahrton G., Tura S., Flesch M. et al. Bone marrow transplantation in multiple myeloma: report from the European Cooperative Group for Bone Marrow Transplantation. Blood 1987;69:1262—4.
7. McElwain T.J., Powles R.L. High-dose intravenous melphalan for plasma-cell leukaemia and myeloma. Lancet 1983;2:822—4.
8. Attal M., Harousseau J.L., Stoppa A.M. et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma: Intergroupe Francais du Myelome. N Engl J Med 1996;335:91—7.
9. Attal M., Harousseau J.L., Facon T. et al. Single versus double autologous stem-cell transplantation for multiple myeloma. N Engl J Med 2003;349(26):2495—502.
10. Cavo M., Zamagni E., Cellini C. et al. Writing committee of the "Bologna 96" clinical trial. Single versus tandem autologous transplants in multiple myeloma: Italian experience. Proceedings of the IXth Myeloma Workshop. J Hematol 2003;4(Suppl 1):60.
11. Segeren C.M., Sonneveld P., van der Holt B. et al. Overall and eventfree survival are not improved by the use of myeloablative therapy following intensified chemotherapy in previously untreated patients with multiple myeloma: a prospective randomized phase 3 study. Blood 2003;10:2144—51.
12. Fermand J.P., Marolleau J.P., Alberti C. et al. Single versus tandem high dose therapy supported with autologous stem cell transplantation using unselected or CD34 enriched ABSC: preliminary results of a two by two designed randomized trial in 23 young patients with multiple myeloma. Blood 2001;98:815.
13. Einsele H., Schafer H.J., Hebart H. et al. Follow-up of patients with progressive multiple myeloma undergoing allografts after reducedintensity conditioning. Br J Haematol 2003;121:411—89.
14. Anderson K.C., Barut B.A., Ritz J. et al. Monoclonal antibody-purged autologous bone marrow transplantation therapy for multiple myeloma. Blood 1991;77(4):712—20.
15. Anderson K.C., Andersen J., Soiffer R. et al. Monoclonal antibodypurged autologous bone marrow transplantation therapy for multiple myeloma. Blood 1993;82(8):2568—76.
16. Reece D.E., Barnett M.J., Connors J.M. et al. Treatment of multiple myeloma with intensive chemotherapy followed by autologous BMT using marrow purged with 4- hydroperoxycyclophosphamide. Bone Marrow Transplant 1993;11(2):139—46.
17. Rhodes E.G.H., Baker P.K., Duguid J.K.M. et al. A method for clinical purging of myeloma bone marrow using peanut agglutinin as an anti-plasma cell agent, in combination with cd19 monoclonal antibody. Bone Marrow Transplant 1992;10(6):485—9.
18. Dimopoulos M.A., Hester J., Huh Y. et al. Intensive chemotherapy with blood progenitor transplantation for primary resistant multiple myeloma. Br J Hematol 1994;87:730—4.
19. Fermand J.P., Chevret S., Levy Y. et al. The role of autologous blood stem cells in support of high-dose therapy for multiple myeloma. Hematol Oncol Clin North Am 1992;6(2):451—62.
20. Fermand J.P., Ravaud P., Chevret S. et al. High-dose therapy (HDT) and autologous blood stem cell transplantation (ABSCT) versus conventional chemotherapy with HDT rescue in multiple yeloma (MM): results of a prospective randomized trial. Blood 1995;86(10 Suppl 1):205.
21. Fermand J.P., Ravaud P., Chevret S. et al. High-dose therapy and autologous blood stem cell transplantation in multiple myeloma: preliminary results of a randomized trial involving 167 patients. Stem Cells 1995;13(Suppl 2):156—9.
22. Kyle R.A. High-dose therapy in multiple myeloma and primary amyloidosis: an overview. Semin Oncol 1999;26(1):74—83.
23. Barlogie B., Kyle R., Anderson K. et al. Comparable survival in multiple myeloma (MM) with high dose therapy (HDT) employing MEL 140 mg/m2 + TBI 12 Gy autotransplants versus standard dose therapy with VBMCP and no benefit from interferon (IFN) maintenance: results of intergroup trial S9321. Blood 2003;102:42.
24. Sirohi B., Powles R., Mehta J. et al. The implication of compromised renal function at presentation in myeloma: similar outcome in patients who receive highdose therapy: a single-center study of 251 previously untreated patients. Med Oncol 2001;18:39—49.
25. Child J.A., Morgan G.J., Davies F.E. et al.; Medical Research Council Adult Leukaemia Working Party. High-dose chemotherapy with hematopoietic stemcell rescue for multiple myeloma. N Engl J Med 2003;348(19):1875—83.
26. Jagannath S. XIth International Myeloma Workshop and the IVth International Workshop on Waldenstr?m’s Macroglobulinemia. The role of bortezomib in myeloma patients eligible for high-dose therapy. Haematologica 2007;92(Suppl 2):abstr 5.3.
27. Chustecka Z. Lenalidomide can significantly extend survival in multiple myeloma. N Engl J Med 2007;357:2123—42.
28. Feyler S., Jackson G., Rawstron A. et al. Thalidomide maintenance following high dose therapy in multiple myeloma: A UK Myeloma Forum Phase II study. Blood 2003;102(Suppl 1):2558.
29. Goldschmidt H., Sonneveld P., Cremer F.W. et al. Joint HOVON-50/GMMG-HD3 randomised trial on the effect of thalidomide as part of a high dose therapy regimen and as maintenance treatment for newly diagnosed myeloma patients. Ann Hematol 2003;82:654—9.
30. Attal M., Harousseau J.L., Leyvraz S. et al. Maintenance treatment with talidomide after autologous transplantation for myeloma: first analysis of a propective randomized study of the Intergroupe Francophone du Myeloma (IFM 99 02). Blood 2004;104:155a.
31. Sahebi F., Somlo G., Kogut N.M. et al. Feasibility and toxicity of maintenance thalidomide following single cycle autologous peripheral blood stem cell transplant in patients with multiple myeloma. Blood 2003;102(Suppl 1):3662.
32. Attal M., Harousseau J.-L., Leyvraz S. et al. Maintenance therapy with thalidomide improves survival in patients with multiple myeloma. Blood 2006;108(10):3289—94.
33. Spencer A., Prince H.M., Roberts A. et al. Thalidomide improve survivals when use after ASCT. Hematologica 2007;92:153.
Рецензия
Для цитирования:
Миненко С.В., Попов А.Ю., Жуков Н.В., Вотякова О.М., Птушкин В.В. Роль высокодозной химиотерапии с трансплантацией клеток-предшественников гемопоэза в лечении множественной миеломы. Онкогематология. 2008;(4):11-16. https://doi.org/10.17650/1818-8346-2008-0-4-11-16
For citation:
Minenko S.V., Popov A.Yu., Zhukov N.V., Votyakova O.M., Ptushkin V.V. Role of high-dose chemotherapy with hemopoietic stem cell transplantation in the treatment of multiple myeloma. Oncohematology. 2008;(4):11-16. (In Russ.) https://doi.org/10.17650/1818-8346-2008-0-4-11-16