[Clinical Analysis of High-Dose Melphalan Combined with Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma].

Abstract

Objective: To investigate the safety, efficacy, and prognosis of high-dose melphalan in combination with autologous hematopoietic stem cell transplantation (ASCT) for the treatment of multiple myeloma (MM).

Methods: The clinical data of 17 patients with newly diagnosed MM who underwent ASCT as first-line consolidation therapy at the Yijishan Hospital of Wannan Medical College from March 2020 to October 2022 were retrospectively analyzed. The safety, efficacy, and prognosis of this treatment approach were evaluated.

Results: Of the 17 patients, 10 were male and 7 were female, with a median age of 56 (45-64) years. The stem cell engraftment rate was 100%, with a median neutrophil engraftment time of +10 (9-12) days and a median platelet engraftment time of +12 (10-21) days. The incidence of oral mucositis and intestinal infection after transplantation was 100%, with 2 cases of pulmonary infection, 1 case of urinary tract infection, 1 case of skin infection, and 11 cases of transient elevation of serum amylase. After transplantation, 13 patients achieved a complete response (CR) or better, and the CR rate showed an increasing trend compared to before transplantation (13/17 vs 8/17; P =0.078). The median follow-up time was 18 (6-36) months, and 15 patients survived without progression, 1 patient experienced disease progression, and 1 patient died due to clinical relapse and abandonment of treatment. The 2-year overall survival (OS) rate and progression-free survival (PFS) rate were approximately 90.0% and 83.9%, respectively.

Conclusion: High-dose melphalan in combination with ASCT as first-line consolidation therapy for MM can enhance the depth of patient response, further improve therapeutic efficacy, and the transplant-related complications are controllable, making it a viable option worth promoting in clinical practice.