Clinical Research on the Improvement of Autologous Stem Cells Collection in Patients with Multiple Myeloma after Velcade-based Chemotherapy_West China Medical Journal

Authors：

HE Dong , LIU Zhigang , YU Qinmei , KUANG Pu , XIANG Bing , HE Chuan , LU Zhongping , LU Jianchun , LIU Ting ,  NIU Ting

Department of Hematology & Research Lab of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

NIU Ting, Email: hedong09@163.com

Keywords：

多发性骨髓瘤; 万珂; 化学疗法; 造血干细胞

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【摘要】　目的　研究以万珂为主化学疗法方案提高多发性骨髓瘤初发患者自体外周血造血干细胞采集的作用。　方法　回顾性分析2006年1月-2010年11月4例初发多发性骨髓瘤患者在万珂治疗后自体外周血造血干细胞采集的临床资料。疗效判定依据国际骨髓瘤工作组2006年疗效判断标准。　结果　经过万珂为主化学疗法方案治疗3~6个疗程（平均4个疗程）后，3例获得CR及以上疗效，均顺利实施了外周血造血干细胞采集；3例采集次数仅1次，1例为2次；平均获得CD34+细胞8.43×106/kg，完全达到采集要求。　结论　万珂为主化学疗法方案起效快、疗效好，可以提高初发多发性骨髓瘤患者的干细胞采集率。
【Abstract】　Objective　 To explore the improvement of autologous stem cells collection in patients with newly-diagnosed multiple myeloma after Velcade-based chemotherapy. 　Methods　 The clinical data of four patients with multiple myeloma who underwent Velcade-based chemotherapy between January 2006 and November 2010 were retrospectively analyzed. The therapeutic effect was observed.　Results　 After 3-6 courses (mean 4 courses) of Velcade-based chemotherapy, 3 patients obtained complete remission (CR) and above response, and the sufficient peripheral blood hematopoietic stem cells were collected successfully. The peripheral blood hematopoietic stem cells were collected once in three patients and twice in one patient. Sufficient number of hematopoietic stem cells (mean CD34 positive-cell 8.43×106/kg) were collected which fully met the collection requirements.　Conclusion　 Velcade-based chemotherapy has advantages of fast action and good therapeutic effect, which can improve the collection of autologous stem cells in patients with newly-diagnosed multiple myeloma.

Citation： HE Dong,LIU Zhigang,YU Qinmei,KUANG Pu,XIANG Bing,HE Chuan,LU Zhongping,LU Jianchun,LIU Ting,NIU Ting. Clinical Research on the Improvement of Autologous Stem Cells Collection in Patients with Multiple Myeloma after Velcade-based Chemotherapy. West China Medical Journal, 2011, 26(4): 521-523. doi: Copy

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11.	Durie BGM, Harousseau J-L, Miguelet JS, et al. International uniform response criteria for multiple myeloma[J]. Leukemia, 2006, 20(10): 1-7.
12.	刘红艳, 夏凌辉, 郭静明, 等. 造血干细胞移植治疗多发性骨髓瘤的研究进展[J]. 武汉大学学报(医学版), 2008, 29(2): 275.
13.	Jesús F, San-Miguel JF, Mateos MV. How to treat a newly diagnosed young patient with multiple myeloma[J]. Hematology Am Soc Hematol Educ Program, 2009(1): 555-565.
14.	Harousseau JL, Attal M, Avet-Loiseau H, et al. Bortezomib plus dexamethasone is superior to vincristine plus doxorubicin plus dexamethasone as induction treatment prior to autologous stem-cell transplantation in newly diagnosed multiple myeloma: results of the IFM 2005-01 phase III trial[J]. J Clin Oncol, 2010, 28(30): 4621-4629.
15.	Corso A, Barbarano L, Mangiacavalli S, et al. Bortezomib plus dexamethasone can improve stem cell collection and overcome the need for additional chemotherapy before autologous transplant in patients with myeloma[J]. Leuk Lymphoma, 2010, 51(2): 236-242.

1. 　叶任高, 陆再英. 内科学[M]. 6版. 北京: 人民卫生出版社, 2004: 631.
2. 　高玉环, 刘海生. 血液系统恶性肿瘤现代非手术治疗[M]. 北京: 科技文献出版社, 2008: 157-158.
3. 　张晓辉, 黄晓军. 造血干细胞移植治疗多发性骨髓瘤的研究进展[J]. 国际输血及血液学杂志, 2007, 30(4): 328-331.
4. 　Adams J. The proteasome: a suitable antineoplastic target[J]. Nat Rev Cancer, 2004, 4(5): 349-360.
5. 　Hideshima T, Miltiades C, Akiyama M, et al. Molecular mechanisms mediating antimyeloma activity of proteasome inhibitor PS-341[J]. Blood, 2003, 101(4): 1530-1534.
6. 　Roccaro AM, Hideshima T, Raje N, et al. Bortezomib mediates antiangi ogenesis in multiple myeloma via direct and indirect effects on endothelia1 cells[J]. Cancer Ras, 2006, 66(1): 184-191.
7. 　National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology Multiple Myeloma (V. 1. 2011). http: //www. nccn. org/peofessionals/physician_gle/PDF/myeloma. pdf.
8. 　Goldschmidt H, Lokhorst HM, Bertsch U, et al. Successful harvesting of peripheral hematopoietic stem cells after induction treatment with bort-ezomib, adriamycin, dexamethasone (PAD) in patients with newly diagnosed multiple myeloma(MM)[J]. Blood, 2008, 112: 3470.
9. 　张之南, 沈悌. 血液病诊断及疗效标准[M]. 3版. 北京: 科学出版社, 2008: 232-235.
10. 　Durie BG. Salmon SE. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival[J]. Cancer, 1975, 36(3): 842-854.
11. 　Durie BGM, Harousseau J-L, Miguelet JS, et al. International uniform response criteria for multiple myeloma[J]. Leukemia, 2006, 20(10): 1-7.
12. 　刘红艳, 夏凌辉, 郭静明, 等. 造血干细胞移植治疗多发性骨髓瘤的研究进展[J]. 武汉大学学报(医学版), 2008, 29(2): 275.
13. 　Jesús F, San-Miguel JF, Mateos MV. How to treat a newly diagnosed young patient with multiple myeloma[J]. Hematology Am Soc Hematol Educ Program, 2009(1): 555-565.
14. 　Harousseau JL, Attal M, Avet-Loiseau H, et al. Bortezomib plus dexamethasone is superior to vincristine plus doxorubicin plus dexamethasone as induction treatment prior to autologous stem-cell transplantation in newly diagnosed multiple myeloma: results of the IFM 2005-01 phase III trial[J]. J Clin Oncol, 2010, 28(30): 4621-4629.
15. 　Corso A, Barbarano L, Mangiacavalli S, et al. Bortezomib plus dexamethasone can improve stem cell collection and overcome the need for additional chemotherapy before autologous transplant in patients with myeloma[J]. Leuk Lymphoma, 2010, 51(2): 236-242.

West China Medical Journal

Clinical Research on the Improvement of Autologous Stem Cells Collection in Patients with Multiple Myeloma after Velcade-based Chemotherapy

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