Study On The Effects Of Autologous Peripheral Blood Stem Cell Transplantation In Multiple Myeloma

Objective:To explore the effects of autologous peripheral blood stem cell transplantation（APBSCT）on survival in patients with Multiple Myeloma（MM）.Methods:27 cases of patients with multiple myeloma（MM）were retrospectively studied,who were hospitalized in Zhangzhou Municipal Hospital Affiliated to Fujian Medical University from January 1^st,2014 to December 31^st,2020.They were all received induction therapy and sequential treatment.Among them,12 patients experienced autologous peripheral blood hematopoietic stem cell transplantation（APBSCT）after induction therapy,while 15 patients without APBSCT treatment.The effects were evaluated in both with and without APBSCT.2.The end points of the study were median progression free survival（PFS）and overall survival（OS）,which were analyzed by the software of SPSS 23.0.Results:1.The median duration from induction therapy to APBSCT was 12（range:5～72）months.The median population of infused CD34⁺cells was 3.91（range:0.55～9.45）×10⁶/L,and the median population of infused mono-nuclear cells was 3.94（range:1.87～7.78）×10⁸/L.The implantation of median neutrophils took 7（range:4～12）days and the median platelets took 12（range:8～19）days after infused stem cells.2.The complete remission（CR）rate was similar before and after APBSCT（CR rate,58%:75%,p=0.1336）.However,the CR rate was improved after APBSCT compared to without APBSCT,p<0.05（p=0.031）.3.Minimal residual disease（MRD）was conducted in 8 cases with APBSCT.2 cases were MRD positive（25%）and 6 cases were MRD negative（75%）after induction therapy.After APBSCT,all 8 cases reached MRD negative（100%）.But there was no statistical significance difference（p>0.05）.4.Transplant-related complications occurred in all the 12 cases during the pre-treatment period and the transplantation process.All cases developed gastrointestinal symptoms,and improved by symptomatic treatments.3 cases experienced fever,which improved by antibiotics treatments.There was no transplant related death.5.The median follow-up time in APBSCT was 43（range:11～81）months,while the median PFS and OS were not reached,and one case died of the disease progression.The median follow-up time in without APBSCT was 38（range:16～8）months,while the median PFS and OS were respectively 45（range:3～66,95%CI 33.052,59.449）months and 45（range:3～66,95%CI 29.895,58.519）months.During the follow-up,5 cases died of relapse or progression.We found that cases with APBSCT had a longer median PFS and median OS than those without APBSCT（p=0.037,p=0.045）.Conclusion:In the era of novel-drugs,autologous peripheral blood stem cell transplantation is safe and effective for multiple myeloma.