Clinical Curative Effect of Early Sequential Therapy Combined with ASCT on Middle-and High-Risk Multiple Myeloma and its Effect on PD-1/PD-L1,T Cell and B Cell Function
Objective:To analyze the clinical curative effect of early sequential therapy combined with ASCT on middle-and high-risk multiple myeloma and its effect on PD-1/PD-L1,T cell and B cell function.Methods:A total of 90 patients with middle-and high-risk multiple myeloma who were treated from January 2019 to May 2022 were selected,and divided into observation group and control group according to the random envelope method.On the basis of intervention and treatment,early sequential therapy combined with ASCT was adopted;the clinical efficacy of patients was evaluated half a year after the intervention;CD3+T cells,CD4+T cells,and CD8+T cells,PD-1 and PD-L1 protein expression levels in peripheral blood were detected before treatment and half a year after treatment;the levels of T cell-related cytokines IFN-γ,TNF-α and B cell-related antibodies IgA,IgM and IgG in the serum of the subjects were detected.Results:The clinical curative effect of the observation group was significantly better than that of the control group(x2=13.586,P＜0.05).After treatment,blood levels of CD3+T cells and CD4+T cells were significantly increased,while CD8+T cells were significantly decreased,with statistically significant difference(t=7.299,2.521,12.629;P＜0.05).After treatment,serum PD-1 and PD-L1 proteins in 2 groups were significantly decreased,and the difference was statistically significant(t=16.315,11.161;P＜0.05).After treatment,serum IFN-γ and TNF-α proteins in 2 groups were significantly increased,with statistically significant difference(t=30.046,32.084;P＜0.05).After treatment,the serum IgA protein was significantly decreased,while IgM and IgG protein were significantly increased in both groups,with statistically significant difference(t=47.013,50.959,27.694;P＜0.05).Conclusion:Early sequential therapy combined with ASCT can effectively improve the clinical efficacy,regulate the levels of PD-1 and PD-L1,and improve the functions of T cells and B cells after intervention in patients with intermediate and high-risk multiple myeloma.
Early sequential therapyAutologous hematopoietic stem cell transplantationMiddle-and high-risk multiple myelomaPD-1/PD-L1T cell functionB cell function
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