Clinical Analysis Of Autologous Hematopoietic Stem Cell Transplantation For Multiple Myeloma

Objective:To explore the prognostic factors of autologous hematopoietic stem cell transplantation(auto-HSCT)in the treatment of multiple myeloma(MM).Methods: We retrospectively assayed 133 MM patients who were admitted to the Department of Hematology,Fujian Medical University Union Hospital between September 2010 and October 2019.The progression-free survival(PFS),Over all survival(OS)and other prognostic factors were analyzed.Results:1.There were 72 patients in the chemotherapy group(49 males and 23females).The median age was 59(41-82)years old.For the staging,stage I,stage II and stage III were 11 cases,17 cases and 41 cases,respectively(3 cases of Missing);For the subtype,Ig G type,Ig A type,light chain type and nonsecretory type were 31 cases,24 cases,15 cases and 1 case,respectively(1 case of Missing);There were 61 patients in the Auto-HSCT group(20 males and 41 females).The median age was 50(29-69)years old,including 26 cases in the single auto-HSCT group,35 cases in the tandem auto-HSCT group;For the staging,stage I,stage II and stage III were 14 cases,29 cases and 18 cases;For the subtype,Ig G type,Ig A type,Ig D type,light chain type and nonsecretory type were 32 cases,3 cases,12 cases,13 cases and 1 case2.Before transplantation,there were 10 cases of CR,13 cases of VGPR,and 8 cases of PR in the tandem transplantation group.There were 9 cases of CR,6 cases of VGPR,and 7cases of PR in the single transplantation group;Taken together,the CR rate before transplantation was 31.1%.After transplantation,the CR rate can be improved to57.4%(p=0.001).3.The median PFS of Auto-HSCT group and chemotherapy group was 65 months and 31 months.The median OS was 73.2 months and 41 months.The5-year PFS rate was 56.2% and 24.9%.The 5-year OS rate was 69.3%,34.8%.4.The median PFS of the single auto-HSCT group and the tandem auto-HSCT group was 16 months and not arrived.The median OS was 32 months and not arrived;The 5-year PFS rate was 34.9% and 58.1%,The 5-year OS rate was 40% and 64.2%.For the high-risk MM subgroup,the 5-year PFS of tandem auto-HSCT and single auto-HSCT were 51.8% and 45.6%(P=0.3711),and the 5-year OS was 63.1% and 39.4%(P=0.1722);5.Univariate and multivariate analysis results: transplantation method is the only factor that affects PFS in MM patients.Conclusion:1.Both single and tandem Auto-HSCT can improve the prognosis of MM patients.2.Tandem auto-HSCT had better PFS and OS than single auto-HSCT.