Clinical Observation Of Chinese Medicine Intervention In Multiple Myeloma Patients With Autologous Hematopoietic Stem Cell Transplantation

Objective:To analyze the security and clinical efficacy of traditional Chinese medicine(TCM)intervention in the whole process of autologous hematopoietic stem cell transplantation(auto HSCT)in the treatment of multiple myeloma(MM)patients.Methods:To retrospectively analyze the clinical data of 20 MM patients who were received treatment in our department between December 2016 and December 2020.The treatment process was divided into three stages:induction of chemotherapy,mobilization and collection of stem cells,pretreatment and reinfusion.Each stage received TCM intervention.(1)Induction of chemotherapy:the patients were given Bushen Huoxue Tongluo decoction;(2)Mobilization and collection of stem cells:patients were given Dongyuan decoction;(3)Pretreatment and reinfusion period:the patients were given Yisui Jiedu Decoction of granules without decocting.The results of induction chemotherapy,the efficacy of hematopoietic stem cells mobilization,the duration of hematopoietic reconstitution,the early complications of transplantation were summarized.And the clinical efficacy of induction therapy and auto HSCT were compared.Finally,to evaluate the clinical effect of TCM intervention in the whole process of auto HSCT on multiple myeloma patientsResults:After transplantation everyone achieved early hematopoietic reconstitution,and there was no transplantation-related death.After induction therapy,the deep remission rate and total effective rate were improved.After hematopoietic stem cell mobilization,15patients(75%)were successfully collected only once,and 5 patients(25%)were successfully collected twice.The median of MNC and CD34+cells were 7.32(5.25-13.28)×10~8/kg and 4.92(2.18-12.94)×10~6/kg,respectively.The median implantation time of neutrophil was 10(7-13)days,and that of platelet was 11(8-13)days.After induction and auto HSCT therapy,CR was 30%(6/20)and 75%(15/20)respectively(P<0.01),and VGPR was 75%(15/20)and 100%(20/20)respectively(P<0.05).After transplantation,all patients were detected by second generation flow cytometry(NGF),of which,15 patients(75%)were negative.The related complications were at a low level within 15 days after transplantation.Up to the follow-up date,18 patients(90%)survived and 3 patients(15%)recurred.Conclusion:In the treatment of multiple myeloma,TCM intervention in the whole process of auto HSCT played the role of synergy and complementary advantages.It can improve the CR rate and deep remission rate for MM patients effectively,enhance the quality of stem cell mobilization.Meanwhile,it can also shortening the time of hematopoietic reconstitution,and reduce adverse reactions.