medecolМедицина и экологияMedicine and ecology2305-60452305-6053Карагандинский медицинский университет10.59598/ME-2305-6045-2024-112-3-67-74medecol-752Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEСравнительная оценка эффективности восстановления гемопоэза у пациентов с множественной миеломой при аутологичной трансплантации костного мозга с применением замороженных и нативных стволовых клетокComparative assessment of the effectiveness of hemapoyesis restoration in patients with multiple myeloma at autologous bone marrow transplantation using frozen and native stem cellsАчиловаО. У.AchilovaO. U.

Озода Умаркуловна Ачилова - отделение трансплантации

100115, г. Ташкент, ул. Арнасай, 17

Ozoda Umarkulovna Achilova - Transplantation Department

100115, Tashkent city, Arnasay str., 17

sachilova@yahoo.comКаюмовА. А.KayumovA. A.

Отделение трансплантации

100115, г. Ташкент, ул. Арнасай, 17

Transplantation Department

100115, Tashkent city, Arnasay str., 17

МахамадалиеваГ. З.MahamadalievaG. Z.

Отделение трансплантации

100115, г. Ташкент, ул. Арнасай, 17

Transplantation Department

100115, Tashkent city, Arnasay str., 17

Республиканский специализированный научно-практический медицинский центр гематологии Министерства здравоохранения Республики УзбекистанУзбекистанRepublican Specialized Scientific and Practical Medical Center for Hematology of the Ministry of Health of the Republic of UzbekistanUzbekistan202424102024036774Copyright © Ачилова О.У., Каюмов А.А., Махамадалиева Г.З., 20242024Ачилова О.У., Каюмов А.А., Махамадалиева Г.З.Achilova O.U., Kayumov A.A., Mahamadalieva G.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medecol.qmu.kz/jour/article/view/752

Цель. Сравнить эффективность и безопасность применения аутологичных гемопоэтических стволовых клеток с заморозкой и без при миеломной болезни.Материалы и методы. Исследование проводилось в отделении трансплантации Республиканского специализированного научно-практического медицинского центра гематологии Министерства здравоохранения Республики Узбекистан и носило ретроспективный характер. Анализировались данные историй болезни 82 пациентов с множественной миеломой, перенесших аутологичную трансплантацию костного мозга в период с 2014 по 2020 г. Больные были разделены на 2 группы: группа I без замораживания стволовых клеток (40 пациентов), группа II – с замораживанием (42 пациента). Средний возраст больных составил 47±4.5 г., соотношение мужчин и женщин – 32 (39%) и 50 (61%). Проанализированы сроки восстановления кроветворения, длительность пребывания в стационаре, жизнеспособность гемопоэтических клеток и 5-летняя общая и безрецидивная выживаемость в обоих группах.Результаты и обсуждение. В группах сразу после афереза периферических гемопоэтических стволовых клеток жизнеспособность составляла 96-98%. В группе I на момент введения количество живых клеток в трансплантате составляло 96-98%. В группе II к моменту трансплантации жизнеспособность была 79-93%, что было связано с потерей клеток в момент замораживания, размораживания и воздействия диметилсульфоксида. Так же применение незамороженного трансплантата сокращало время восстановления кроветворения после пересадки до 11 сут, в то время как замороженный трансплантат восстанавливался к 15 сут. Осложнения, связанные с токсичностью консерванта, регистрировались в группе II у 100% больных. Разницы в 5-летней общей и безрецидивной выживаемости в исследовании не выявлено. В группе I безрецидивная выживаемость составила 63%, в группе II – 60% (p=0,2). При оценке общей 5-летней выживаемости между группами существенной разницы не было (78 и 74%; р=0,1).Выводы. Полученные в исследовании данные позволяют сделать вывод о том, что трансплантация незамороженных периферических гемопоэтических стволовых клеток является эффективным и безопасным методом. Не выявлено существенной разницы при сопоставлении отдаленных результатов с криозамороженными периферическими гемопоэтическими стволовыми клетками.

Purpose of the study. To compare the effectiveness and safety of using autologous hematopoietic stem cells without freezing in multiple myeloma.Materials and methods. The study was carried out in the transplantation department of the Republican Scientific and Practical Medical Center of the Ministry of Health of the Republic of Uzbekistan. The study included 82 patients with multiple myeloma who underwent autologous bone marrow transplantation between 2014 and 2020 and was retrospective in nature based on medical records. The patients were divided into 2 groups – I without freezing (40 patients), II – with freezing of stem cells (42 patients). The average age was 47±4.5 years, the male to female ratio was 32 (39%) and 50 (61%), respectively. The timing of hematopoietic restoration, length of hospital stay, viability of hematopoietic cells and 5-year overall and relapse-free survival in both groups were analyzed.Results and discussion. In the study groups, immediately after apheresis of peripheral hematopoietic stem cells, viability was 96-98%. In group I, at the time of administration, the number of living cells in the graft was the same 96-98%, and in group II, at the time of transplantation, viability was at the level of 79-93%, which was associated with cell loss during freezing, thawing and exposure to Dimethylsulfoxide. Also, the use of an unfrozen transplant increased the recovery time of hematopoiesis after transplantation to 11 days, while the frozen transplant was restored by the 15th day. Complications associated with preservative toxicity occurred in group II in 100% of patients. The study did not reveal any difference in 5-year overall and disease-free survival. In group I, relapse-free survival was 63%, in group II -60% (p = 0.2). When assessing overall 5-year survival between groups I and II, there was also no significant difference: 78% and 74% (p = 0.1).Conclusions. The data obtained in the study allow us to conclude that transplantation with non-frozen peripheral hematopoietic stem cells is an effective and safe method and does not have a significant difference when comparing long-term results in cryofrozen peripheral hematopoietic stem cells.

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The authors declare that there are no conflicts of interest present.