Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma

Morie Gertz, Martha Lacy, D. J. Inwards, M. G. Chen, A. A. Pineda, D. A. Gastineau, P. R. Greipp, J. A. Lust, Ayalew Tefferi, Thomas Elmer Witzig, R. A. Kyle, Mark R Litzow

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Transplantation after high-dose chemotherapy prolongs survival in patients with multiple myeloma compared with standard therapy. It is unclear whether the optimal timing of transplantation is immediately after induction chemotherapy or whether stem cells may be cryopreserved for transplantation at subsequent progression or relapse. In this study, stem cells were collected within 6 months of diagnosis, followed by transplantation only at progression of myeloma. One hundred and eighteen patients with multiple myeloma had stem cells collected and cryopreserved. Eleven had transplants early in the disease after they demonstrated failure to respond to primary therapy. The remaining 107 were eligible for transplants when there was evidence of progressive disease. Of the 118 patients, 67 had transplants, nine died of progressive disease before transplantation, and 42 remain alive in plateau phase. The median survival of the group is 58.5 months; 67 are alive. Serum β2-microglobulin, bone marrow labeling index (S phase), and hemoglobin level predicted overall survival (P < 0.006, P < 0.001, and P < 0.01, respectively). We conclude that early cryopreservation of blood stem cells followed by transplantation at progression is a feasible approach to therapy in patients with myeloma. The underlying biology of the disease has a greater impact on survival than the timing of transplantation. A prospective randomized trial is required to answer definitively the question of the optimal timing of blood cell transplantation.

Original languageEnglish (US)
Pages (from-to)221-226
Number of pages6
JournalBone Marrow Transplantation
Volume23
Issue number3
StatePublished - 1999

Fingerprint

Multiple Myeloma
Transplantation
Stem Cells
Survival
Transplants
Blood Cells
Therapeutics
Induction Chemotherapy
Cryopreservation
Cell Transplantation
Stem Cell Transplantation
S Phase
Hemoglobins
Bone Marrow
Recurrence
Drug Therapy
Serum

Keywords

  • Blood cell transplantation
  • Multiple myeloma
  • Myeloma prognosis
  • Stem cell

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma. / Gertz, Morie; Lacy, Martha; Inwards, D. J.; Chen, M. G.; Pineda, A. A.; Gastineau, D. A.; Greipp, P. R.; Lust, J. A.; Tefferi, Ayalew; Witzig, Thomas Elmer; Kyle, R. A.; Litzow, Mark R.

In: Bone Marrow Transplantation, Vol. 23, No. 3, 1999, p. 221-226.

Research output: Contribution to journalArticle

Gertz, M, Lacy, M, Inwards, DJ, Chen, MG, Pineda, AA, Gastineau, DA, Greipp, PR, Lust, JA, Tefferi, A, Witzig, TE, Kyle, RA & Litzow, MR 1999, 'Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma', Bone Marrow Transplantation, vol. 23, no. 3, pp. 221-226.
Gertz, Morie ; Lacy, Martha ; Inwards, D. J. ; Chen, M. G. ; Pineda, A. A. ; Gastineau, D. A. ; Greipp, P. R. ; Lust, J. A. ; Tefferi, Ayalew ; Witzig, Thomas Elmer ; Kyle, R. A. ; Litzow, Mark R. / Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma. In: Bone Marrow Transplantation. 1999 ; Vol. 23, No. 3. pp. 221-226.
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