New progress of autologous hematopoietic stem cell transplantation in the treatment of multiple myeloma / 中国组织工程研究

ABSTRACT

BACKGROUND:Autologous hematopoietic stem celltransplantation is an effective treatment for multiple myeloma. After chemotherapy, autologous hematopoietic stem celltransplantation becomes a standard therapeutic regimen for multipla myeloma, and numerous units and centers have reported that. How to reduce toxic and adverse reactions of the drugs, transplantation-related complications and improvement of long-term survival have been present foci. OBJECTIVE:To summarize the new progress of autologous hematopoietic stem celltransplantation in the treatment of multiple myeloma. METHODS:We retrieved PubMed and China National Knowledge Infrastructure database, Vip database, Wanfang database, free medicaljournals.com source for articles published from January 2006 to November 2012 concerning autologous hematopoietic stem celltransplantation in the treatment of multiple myeloma. The key words were“autologous hematopoietic stem celltransplantation, multiple myeloma”. A total of 46 articles were included. RESULTS AND CONCLUSION: Large-dose chemotherapy combined with autologous hematopoietic stem celltransplantation for multiple myeloma obtained better outcomes compared with the traditional chemotherapy. However, many patients could not relieve after single autologous hematopoietic stem celltransplantation, and the disease recurred final y. Al ogeneic hematopoietic stem celltransplantation was limited by donor source, and treatment-associated fatality rate was high, so its use was confined. Therefore, present new development direction included twice autologous hematopoietic stem celltransplantation, autologous transplantation combined with al ogeneic transplantation with reduced-intensity conditioning regimens as wel as drug on the basis of single autologous hematopoietic stem celltransplantation. Novel drug proteasomes inhibitor and immunomodulator in inducer remission, pretreatment and sustaining stages obviously improved total reaction rate of multiple myeloma therapy and long-term survival.