• 四川大學(xué)華西醫(yī)院血液科 血液病研究室（成都，610041）;

【摘要】　目的　 研究以萬珂為主化學(xué)療法方案提高多發(fā)性骨髓瘤初發(fā)患者自體外周血造血干細(xì)胞采集的作用。　方法　 回顧性分析2006年1月-2010年11月4例初發(fā)多發(fā)性骨髓瘤患者在萬珂治療后自體外周血造血干細(xì)胞采集的臨床資料。療效判定依據(jù)國際骨髓瘤工作組2006年療效判斷標(biāo)準(zhǔn)。　結(jié)果　 經(jīng)過萬珂為主化學(xué)療法方案治療3~6個療程（平均4個療程）后，3例獲得CR及以上療效，均順利實(shí)施了外周血造血干細(xì)胞采集；3例采集次數(shù)僅1次，1例為2次；平均獲得CD34+細(xì)胞8.43×106/kg，完全達(dá)到采集要求。　結(jié)論　 萬珂為主化學(xué)療法方案起效快、療效好，可以提高初發(fā)多發(fā)性骨髓瘤患者的干細(xì)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.

引用本文： 何東,劉志剛,喻琴梅,鄺璞,向兵,何川,盧忠平,魯建春,劉霆,牛挺. 萬珂提高多發(fā)性骨髓瘤干細(xì)胞采集的臨床研究. 華西醫(yī)學(xué), 2011, 26(4): 521-523. doi: 復(fù)制

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  1. 1. 　葉任高, 陸再英. 內(nèi)科學(xué)[M]. 6版. 北京: 人民衛(wèi)生出版社, 2004: 631.
  2. 2. 　高玉環(huán), 劉海生. 血液系統(tǒng)惡性腫瘤現(xiàn)代非手術(shù)治療[M]. 北京: 科技文獻(xiàn)出版社, 2008: 157-158.
  3. 3. 　張曉輝, 黃曉軍. 造血干細(xì)胞移植治療多發(fā)性骨髓瘤的研究進(jìn)展[J]. 國際輸血及血液學(xué)雜志, 2007, 30(4): 328-331.
  4. 4. 　Adams J. The proteasome: a suitable antineoplastic target[J]. Nat Rev Cancer, 2004, 4(5): 349-360.
  5. 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. 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. 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. 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. 9. 　張之南, 沈悌. 血液病診斷及療效標(biāo)準(zhǔn)[M]. 3版. 北京: 科學(xué)出版社, 2008: 232-235.
  10. 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. 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. 12. 　劉紅艷, 夏凌輝, 郭靜明, 等. 造血干細(xì)胞移植治療多發(fā)性骨髓瘤的研究進(jìn)展[J]. 武漢大學(xué)學(xué)報(醫(yī)學(xué)版), 2008, 29(2): 275.
  13. 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. 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. 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.