Objective: To evaluate the effect of autologous stem cell transplantation (auto-HSCT) on treatment remission and survival of newly diagnosed multiple myeloma (MM) patients. Methods: A total of 243 new diagnosed MM patients (age ≤65 years) who had received auto-HSCT were selected, and 176 MM patients (age ≤65 years) who had not received auto-HSCT were selected as the control group to evaluate the effect of auto-HSCT on the remission and survival. To balance the distribution of prognostic factors between auto-HSCT and non-auto-HSCT patients, the propensity score matching technique was used to reduce the bias between groups in a 1∶1 scale, 64 in each group, and correlation analysis was performed. Results: A total of 128 patients (64 cases in each group) were screened by propensity score matching analysis. 64 patients received auto-HSCT after induction therapy. After auto-HSCT, 24 patients (37.5%) obtained sCR, 16 patients (25.0%) obtained CR, 15 patients (23.4%) obtained VGPR, and 9 patients (14.1%) obtained PR. The efficacy of patients with auto-HSCT was significantly better than that of non-auto-HSCT patients (P=0.032) . Progression-free survival (PFS) and overall survival (OS) were significantly longer in auto-HSCT patients compared with non-auto-HSCT patients[PFS: 42.2 (95% CI 29.9-54.5) months vs 22.4 (95% CI 17.1-27.7) months, P=0.007; OS: 87.6 (95% CI 57.3-117.9) months vs 53.9 (95% CI 36.1-71.7) months, P=0.011]. Multivariate analysis confirmed that auto-HSCT had a favorable effect on OS (HR=0.448, 95%CI 0.260-0.771, P=0.004) and PFS (HR=0.446, 95%CI 0.280-0.778, P=0.003) . Conclusion: These results demonstrated that auto-HSCT was a favorable prognostic factor for newly diagnosed MM patients.
目的： 评估自体造血干细胞移植（auto-HSCT）对初治多发性骨髓瘤（MM）疗效及生存的影响。 方法： 回顾性分析2008年10月1日至2019年10月1日243例65岁以下接受auto-HSCT的初治MM患者，同时以同期176例≤65岁适合移植但未进行auto-HSCT的初治MM患者作为对照，评估auto-HSCT对患者疗效及生存的影响。为平衡auto-HSCT和非auto-HSCT患者之间各因素的分布，利用倾向性评分匹配技术按照1∶1比例匹配以减少组间的偏差。 结果： 通过倾向性评分匹配分析，共筛选出128例患者（每组64例）。64例患者诱导治疗后接受auto-HSCT，24例（37.5%）获得严格意义的完全缓解（sCR），16例（25.0%）获得完全缓解（CR），15例（23.4%）获得非常好的部分缓解（VGPR），9例（14.1%）获得部分缓解（PR），auto-HSCT组疗效明显优于非auto-HSCT组（P=0.032）。与非auto-HSCT组相比，auto-HSCT组总生存（OS）和无进展生存（PFS）期明显延长[OS：87.6（95% CI 57.3~117.9）个月对53.9（95% CI 36.1~71.7）个月，P=0.011；PFS：42.2（95% CI 29.9~54.5）个月对22.4（95% CI 17.1~27.7）个月，P=0.007]。多因素分析显示auto-HSCT是OS（HR=0.448，95%CI 0.260~0.771，P=0.004）和PFS（HR=0.446，95%CI 0.280~0.778，P=0.003）的独立保护因素。 结论： auto-HSCT可改善适合移植初治MM患者的OS和PFS。.
Keywords: Autologous stem cell transplantation; Multiple myeloma; Prognostic factors; Survival.