Autologous bone marrow transplantation for multiple myeloma

Division of Hematology/Oncology, University of Arkansas for Medical Sciences, Little Rock.
Hematology/Oncology Clinics of North America (Impact Factor: 2.3). 05/1992; 6(2):437-49.
Source: PubMed


Intensive cytotoxic chemotherapy is capable of more marked tumor cytoreduction including true complete remissions in multiple myeloma. Use of autologous marrow and blood stem cells as well as growth factors has reduced the risk of infection and severe extramedullary toxicities.

0 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Das multiple Myelom, eine maligne Plasmazell-Dyskrasie, ist bis heute unheilbar. Eine Verbesserung des medianen Überlebens von weniger als 2 auf über 3 Jahre wurde erstmals 1996 durch eine prospektiv randomisierte Studie von Attal et al. gezeigt. Die retrospektive Analyse zweier zeitlich definierter Kohorten, Kohorte 1 (1990-1996) und Kohorte 2 (1997-2002), zur Überprüfung des Therapieerfolges am Universitätsklinikum Würzburg zeigt unter Berücksichtigung aller Patienten keinen Überlebensvorteil für Patienten der 2.Kohorte. Signifikant profitiert haben allerdings Patienten bis max. 65 Jahre der Kohorte 2, die durch die HD-Therapie ein 5-JÜL von 50% (Kohorte 2) vs.32% (Kohorte 1) erreichten, wohingegen sich für ältere Patienten keine signifikant messbaren Überlebensvorteile ergaben. The median overall survival of patients with multiple myeloma did not exceed more than 2 years for a long time. 1996 Attal et al. published a randomized prospective trial that showed a median survival of more than 3 years in patients who went through a high-dosed chemotherapy and autologous stem cell transplantation. This retrospective analysis in two cohorts compares the overall survival rates of newly diagnosed myeloma patients between 1990-1996 (cohort 1) and 1997-2002 (cohort 2). A significant benefit in 5 year survival rates could be shown for patients younger or max. 65 years(50% C.2 vs. 32% C.1). The overall survival of patients older than 65 years, who did not receive a high-dose therapy, did not improve. The high-dose therapy with autologous stem cell retransfusion seems to be the most important factor to improve the overall survival of patients.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report on a patient suffering from multiple myeloma, for whom allogeneic bone marrow transplantation was planned. Donor workup revealed monoclonal gammopathy of unknown significance. We discuss this finding and stress the importance of performing complete donor examinations.
    Annals of Hematology 03/1993; 66(2):93-5. DOI:10.1007/BF01695891 · 2.63 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sixty-three patients with high tumor mass multiple myeloma were treated with high-dose chemotherapy and total body irradiation supported by autologous blood stem cell transplantation. After high-dose therapy, they were monitored for a median of 44 months. Seven patients died early from toxicity. All the other patients, including those whose disease was resistant to previous therapies, showed a tumor mass reduction. At 6 months postengraftment, 40 (71%) of the surviving patients had minimal residual disease and 11 (20%) were in apparent complete remission. During follow-up, 25 out of the 63 (39%) patients relapsed and 16 of these died; 31 (49%) had a sustained remission. The median overall and event-free survival times after transplantation were 59 and 43 months, respectively. The initial serum beta 2-microglobulin value (> or < 2.8 mg/L) and length of previous therapy (> or < 6 courses of chemotherapy) were the only significant prognostic factors. In all surviving patients, blood stem cell autograft provided satisfactory and sustained haematopoietic reconstitution most often within 15 days. High dose chemoradiotherapy followed by autologous blood stem cell transplantation is thus an important therapeutic option for young patients with aggressive multiple myeloma.
    Blood 10/1993; 82(7):2005-9. · 10.45 Impact Factor
Show more

Similar Publications