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在多发性骨髓瘤患者自身干细胞移植前间隔进展的影响

Alicia Bao¹, Qiuhong Zhao², Ruchi Kudalkar¹

¹The Ohio State University, College of Medicine, Columbus, OH, United States.

Frontiers in oncology

|August 9, 2023

概括

在自身干细胞移植 (ASCT) 之前,26%的多发性骨髓瘤患者发生间隔进展 (IP). 这种进展影响了无进展生存,特别是在VRD诱导后,并且与特定的T细胞和NK细胞变化有关.

科学领域:

血液学血液学血液学
免疫学免疫学免疫学
在瘤学瘤学.

背景情况:

标准多发性骨髓瘤 (MM) 治疗包括诱导疗法,其次是自身干细胞移植 (ASCT).
在诱导完成和干细胞调动的ASCT之间存在必要的间隔,在此期间疾病进展可能发生 (间隔进展,IP).

研究的目的:

调查间隔进展 (IP) 对接受ASCT的可移植多发性骨髓瘤 (MM) 患者的发病率和结果的影响.
在MM患者中探索IP的潜在免疫学相关物.

主要方法:

在2011年至2016年期间接受ASCT的408名MM患者的回顾性分析.
基于临床数据的IP发生率评估.
使用单变量和多变量模型进行无进展生存 (PFS) 分析.
在35名患者的子组中,在ASCT时对外周血液T细胞和自然杀手细胞 (NK) 进行免疫类型定型.

主要成果:

26%的总队列和23.6%的接受博特佐米布-莱纳利多米德-脱萨 (VRD) 诱导的患者经历了IP.
在整个队列的单变量分析中,IP与较短的PFS有关,但在多变量分析中并非如此.
在接受VRD诱导的患者中,在单变量和多变量分析中,IP与劣质PFS有显著的相关性.
患有IP的患者在ASCT显示特定T细胞子集 (CD3+CD8+CD57+CD28-,CD3+CD4+LAG3+) 的百分比增加,激活NK细胞的百分比减少.

结论:

间隔进展 (IP) 是多发性骨髓瘤患者接受ASCT的显著临床事件,影响结果.
IP对PFS的负面影响在接受VRD诱导治疗的患者中尤为明显.
在IP的MM患者中观察到T细胞和NK细胞种群的明显变化,这表明免疫失调的作用.
需要进一步的研究,以优化经历IP的MM患者的管理,以改善治疗反应和存活率.

关键词:

疾病的进展疾病的进展免疫特征分析免疫特征分析骨髓瘤多样性骨髓瘤多样性结果结果结果结果.干细胞移植 (SCT) 干细胞移植

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