在同时发生多发性骨髓瘤和慢性骨髓性白血病时,基于达拉图穆马布的诱导和自身移植
Carmine Liberatore1, Francesca Fioritoni1, Annalisa Natale2
1Hematology Unit, Department of Oncology and Hematology Pescara Hospital Pescara Italy.
EJHaem
|November 29, 2023
概括
这项研究详细介绍了一种罕见的慢性髓性白血病 (CML) 和多发性髓瘤 (MM) 共同发生的病例. 用达拉-VTd,伊马替尼和自身干细胞移植治疗是有效的,证明了可行性和成功的干细胞动员.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 干细胞移植 干细胞移植
背景情况:
- 慢性髓性白血病 (CML) 和多发性髓瘤 (MM) 的同时存在非常罕见.
- 调查这些共存的血液性恶性瘤的独特的克隆起源至关重要.
研究的目的:
- 报告第一个CML和MM病例,该病例是用daratumumab诱导和自身干细胞移植 (ASCT) 治疗的.
- 评估Dara-VTd与伊马替尼布联合治疗的可行性和疗效.
- 评估用daratumumab治疗的患者的干细胞调动和采集.
主要方法:
- 对CD138血细胞和CD34干细胞进行FISH和分子分析,以确定克隆起源.
- 治疗方案包括达拉图马布,博尔特佐米布,沙利多米德,德克萨米他 (Dara-VTd) 诱导,干细胞采集和ASCT.
- 高剂量环胺 (4g/m2) 与plerixafor用于干细胞调动.
主要成果:
- 证实了CML和MM的不同克隆起源.
- 联合达拉-VTd和伊马替尼布治疗对于这两种恶性瘤都是可行的,并且非常有效.
- 尽管暴露于达拉图穆马布,但仍能达到最佳的干细胞动员和采集,使用高剂量的环胺和plerixafor.
- ASCT成功进行,并进行了快速的血液学复制.
结论:
- 达拉-VTd与伊马替尼布的组合有效地管理共存的CML和MM.
- 高剂量环胺与plerixafor促进成功的干细胞动员和收集在治疗达拉图姆巴的患者.
- 对于患有共存CML和MM的患者来说,ASCT是一种可行的治疗选择,即使在暴露于达拉图穆马布后.
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