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课件:多发性骨髓瘤的造血干细胞移植.ppt
异基因移植的优势 Allogeneic Bone Marrow Transplantation for Multiple Myeloma Associated with high complete response rates Durable molecular remissions are noted in some patients Two advantages which may reduce the risk of relapse after allogeneic transplant compared with autologous transplant are: infusion of a tumor free stem cell product graft versus myeloma effect High dose conventional allogeneic transplantation is associated with a high treatment related mortality, up to 50% in some studies Evidence for a Graft versus Myeloma (GVM) Effect Delayed disappearance of residual disease after allogeneic BMT in some patients Decreased rate of relapse after allogeneic BMT compared with autologous BMT 40%-80% overall response rate in patients with relapsed multiple myeloma after donor lymphocyte infusion Response to CD4+ DLIN=12 Pre DLI Maximal Response Current status 9-persistent or 6 CR 5 CR-1 Relapse Progressive disease 3 PR 2 relapse 3-CR - 2 CR-1 relapse 浆细胞白细胞的移植 Primary plasma cell leukemia and autologous stem cell transplantation haematologica | 2010; 95(5):804-9 Primary plasma cell leukemia(PCL): less than 5% of malignant PCD. It has a poor prognosis, median survival of 8-12 months. Autologous stem cell transplantation may improve survival. A retrospective analysis(European Group for Blood and Marrow Transplantation): 272 patients PCL and 20844 with MM undergoing first autologous transplantation between 1980 and 2006. mSMART2.0: Classification of Active MM 3 years 5 years 7-10 years FISH Del 17P t(14:16) t(14:20) GEP High risk signature FISH t(4:14) Cytogenetic deletion 13 or hypodiploid PCLI≥3% All others including: Hyperdiploid t(11:14) t(
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