Objective To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in young patients with high-risk multiple myeloma(HRMM)and analyzed the factors affecting patient prognosis.Methods In this retrospective study,we analyzed the clinical data of 14 patients with HRMM with cytogenetic abnormalities or high-risk biological factors who underwent allo-HSCT at the Hematopoietic Stem Cell Transplantation Center of the Institute of Hematology & Blood Diseases Hospital between November 2016 and November 2022.Results There were seven males and seven females included in the study,with a median age of 39.5(31-50)years at the time of allo-HSCT.The median number of treatment lines before transplantation was 2(1-6).Before allo-HSCT,42.9％(6/14)of the patients did not achieve complete remission,while 35.7％(5/14)of the patients achieved measurable residual disease positivity.After transplantation,all patients were evaluated for their treatment response,and the overall response rate was 100％(14/14).All 14 patients successfully underwent allo-HSCT,with median engraftment times for neutrophils and platelets of 11(10-14)days and 13(9-103)days,respectively.Acute grade Ⅱ-Ⅳ graft-versus-host disease(GVHD)occurred in five patients(35.7％),and two patients(14.3％)developed moderate-to-severe chronic GVHD.The median follow-up time after allo-HSCT was 18.93(4.10-72.53)months,with an expected 2-year transplant-related mortality rate of 7.1％(95％CI 0％-21.1％)and an expected 2-year overall survival rate of 92.9％(95％CI 80.3％-100.0％).Moreover,the expected 1-year and 2-year progression-free survival rates were 92.9％(95％CI 80.3％-100.0％)and 66.0％(95％CI 39.4％-100.0％),respectively,and the 2-year cumulative incidence of relapse was 28.9％(95％CI 0％-56.7％).Upfront allo-HSCT following complete remission after induced therapy and the presence of chronic GVHD might be favorable prognostic factors.Conclusion allo-HSCT is an effective treatment for improving the prognosis of young patients with HRMM.
维普
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