文章：

硼替佐米、来那度胺和地塞米松（VRd）联合治疗后进行自体干细胞移植治疗多发性骨髓瘤

Bortezomib, lenalidomide, and dexamethasone (VRd) followed by autologous stem cell transplant for multiple myeloma

原文发布日期：2018-11-08

DOI: 10.1038/s41408-018-0147-7

类型: Article

开放获取: 是

英文摘要：

We retrospectively reviewed all patients (n = 243) receiving bortezomib, lenalidomide, and dexamethasone (VRd) induction followed by autologous stem cell transplantation (ASCT) for multiple myeloma at the Mayo Clinic between January 2010 and April of 2017. Median age was 61 (interquartile range, 55–67) with 62% of patients being male. High-risk cytogenetic abnormalities (HRA) were present in 34% of patients. A total of 166 (68%) patients received some form of maintenance/other therapy post transplant (no maintenance (NM, n = 77), lenalidomide maintenance (LM, n = 108), bortezomib maintenance (BM, n = 39), and other therapy (OT, n = 19)). Overall response rate at day 100 post ASCT was 99% (CR 42%) with CR rate increasing to 62% at time of best response post transplant. Two year and 5 year overall survival rates were 90% and 67%, respectively, with an estimated median overall survival (OS) and progression-free survival (PFS) of 96 and 28 months, respectively. HRA was associated with a worse OS but not PFS (median OS: not reached for standard risk vs 60 months for HRA, P = 0.0006; median PFS: 27 months for standard risk vs 22 months for HRA, P = 0.70). The combination of VRd followed by ASCT is a highly effective regimen producing deep and durable responses in many patients.

摘要翻译： 

我们回顾性分析了2010年1月至2017年4月期间在梅奥诊所接受硼替佐米、来那度胺和地塞米松（VRd）诱导治疗后进行自体干细胞移植（ASCT）治疗多发性骨髓瘤的所有患者（n=243）。中位年龄为61岁（四分位距，55-67），其中62%的患者为男性。34%的患者存在高风险细胞遗传学异常（HRA）。共有166例（68%）患者在移植后接受了某种形式的维持/其他治疗（无维持（NM, n=77）、来那度胺维持（LM, n=108）、硼替佐米维持（BM, n=39）和其他治疗（OT, n=19））。ASCT后100天的总缓解率为99%（完全缓解42%），移植后最佳缓解时的完全缓解率升至62%。2年和5年总生存率分别为90%和67%，估计中位总生存期（OS）和无进展生存期（PFS）分别为96个月和28个月。HRA与较差的总生存期相关，但不影响无进展生存期（中位OS：标准风险未达到 vs HRA 60个月，P=0.0006；中位PFS：标准风险27个月 vs HRA 22个月，P=0.70）。VRd后接ASCT的组合方案是一种高效方案，在许多患者中产生深度持久的缓解。

原文链接：

Bortezomib, lenalidomide, and dexamethasone (VRd) followed by autologous stem cell transplant for multiple myeloma