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大剂量化疗(HDC)后施以造血干细胞移植比传统的标准化疗延长多发性骨髓瘤(MM)患者的生存期,但移植的最佳时机尚不清楚。本文报告了为MM患者早期采集造血干细胞用于晚期移植的结果,旨在最大限度地延长患者的生存期。 118例MM患者中男70例,女48例。中位年龄52(24～68)岁。近三分之一的患者Hb≤10g/dl,65％的患者β_2M升高,35％的患者反映疾病活动性的标志指数>0.8％。所有患者均给VAD方案(长春新碱、阿霉素及强的松)化疗4个周期以后进行干细胞采集。最初14例没给任何动员,在稳定状态下采集。46例给G-CSF(5μg/kg·d)第5天开始采集。后来58例给CTX(1.5g/kg·d×2)及G-CSF动员后采集。WBC>500/μl时开始于细胞采集,平均在4小时内处理循环血液14升,采集目标
High-dose chemotherapy (HDC) followed by hematopoietic stem cell transplantation prolongs the survival of multiple myeloma (MM) patients compared to conventional standard chemotherapy, but the optimal timing for transplantation is not known. This article reports the results of early harvesting of hematopoietic stem cells for advanced transplantation in MM patients to maximize patient survival. Among 118 patients with MM, 70 were male and 48 were female. The median age was 52 (24-68) years old. Nearly one-third of patients had Hb ≤ 10 g/dl, 65% of patients had elevated β_2M, and 35% had a marker of disease activity > 0.8%. All patients received stem cell harvesting after 4 cycles of chemotherapy with VAD regimens (vincristine, doxorubicin, and prednisone). The first 14 cases did not give any mobilization and were collected under steady state. 46 cases were collected on the fifth day of G-CSF (5 μg/kg·d). Later, 58 cases were collected after mobilization of CTX (1.5g/kg·d×2) and G-CSF. When WBC > 500/μl, cell collection begins, and an average of 14 liters of circulating blood is processed within 4 hours.