万珂在sct治疗mm的临床应用ppt课件.ppt

基因表达谱(GEP)定义的危险因素的临床结果 以70基因模型判断的GEP ~ 15%的极高危患者 Barlogie B, et al. ASCO 2007, abstract # 8020 结果 低危 高危 P 值 OS 91% 70% 0.0002 EFS 90% 58% 0.0001 持续CR 比例 94% 60% 0.0008 GEP定义的低危组：TT3 优于 TT2 GEP定义的高危组：TT3 优于 TT2 如果已考虑GEP危险评分，则T(4;14) 对生存没有影响 EFS (P=0.002) CR持续比例(P=0.01) EFS (P=0.05) 加用万珂的TT3试验 诱导和巩固 安全性: 2级不良事件： 周围神经病变和深静脉血栓；治疗相关死亡率低，24个月时为5%。 结论: TT3方案依从性高，治疗相关死亡率低 TT3显著有效 (60%CR和80%≥nCR) 24个月时OS 87%, EFS 84%, 和持续CR 91% 根据GEP定义高危和低危组 GEP危险评分抵消了 t(4;14) 的预后意义 TT3 优于 TT2: GEP定义的低危组：EFS和持续CR比例 t(4;14) 亚组：OS Barlogie B, et al. ASCO 2007, abstract # 8020 加用万珂的TT3试验 诱导和巩固 请您补充内容，谢谢！ 总 结 * 造血干细胞移植治疗MM的新进展 1、干细胞移植方面 2、干细胞采集的影响－没有影响 3、诱导治疗的新资料 4、预处理方案中加入万珂－最新资料 5、移植后的维持治疗 * As we know that in the past half centries, allo-HSCT has been developed as an very important therapy for many hematologic and nonhematologic disorders, such as leukemia, even a sole cure for …… HSCT has two major categries, auto- and allo-. Slide 6: The most common indications for autologous transplantation in North America in 2003 were multiple myeloma and lymphoma, accounting for an estimated 8,000 transplants. The most common indications for allogeneic transplantation in North America were leukemia and myelodysplasia, accounting for an estimated 5,000 transplants. * * Improved responses in 18/28 pts with dex * * /treatments/3.05.03.html Velcade (PS-341)/Adriamycin/Dexamethasone (PAD). The combination of Velcade, Adriamycin (doxorubicin) and dexamethasone is being evaluated as front-line therapy in a study being conducted in the UK. (Oakervee et al. Br J Haematol. 2005;129(6):755-762.) The rationale to using this regimen is that dexamethasone adds to the efficacy of Velcade, and in the lab, adding a cytotoxic agent such as doxorubicin has a synergistic effect. In this study, patients receive Velcade at the standard dose (1.3 mg/m2 on days 1, 4, 8, and 11 of each 21-day cycle), Adriamycin (0, 4.5, or 9 mg/m2 during days 1-4 of each cycle) and dexamethasone (40 mg on days 1-4, 8-11, and