Refractory and relapsing multiple myeloma treated by blood stem cell transplantation

Morie Gertz, A. A. Pineda, M. G. Chen, L. Letendre, P. R. Greipp, L. A. Solberg, Thomas Elmer Witzig, J. P. Garton, D. J. Inwards, Mark R Litzow, Ayalew Tefferi, R. A. Kyle, P. Noel

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Between June 1989 and June 1992, 12 patients with advanced multiple myeloma underwent peripheral blood stem cell autotransplantation after high- dose chemotherapy and radiotherapy. The conditioning regimen included melphalan (140 mg/m2), high-dose cyclophosphamide (120 mg/kg), methylprednisolone (2 g daily x 7), and total body irradiation (9-12 Gy). Transplant morbidity included severe mucositis (n = 7) and acute renal failure (n = 2) related to infusion of the stem cells. Engraftment was delayed (n = 4) in this heavily pretreated population, and two patients had complete graft failure. Despite the advanced nature and chemotherapy- refractory state of their disease, 11 of 11 evaluable patients achieved an objective response. Six patients survived to leave the hospital, and four remain alive-one died of acute leukemia induced by prior melphalan exposure. Three of the four are relapse-free at a median of 24.9 months (range, 18-28 months). Some patients with advanced refractory multiple myeloma can achieve objective responses from high-dose chemoradiotherapy with peripheral blood stem cell rescue. Harvesting peripheral blood stem cells from high-risk patients early in their disease for later use may decrease the risk of graft failure. Peripheral blood stem cell transplantation after high-dose chemotherapy and total body irradiation can produce durable responses in patients with advanced refractory myeloma.

Original languageEnglish (US)
Pages (from-to)152-161
Number of pages10
JournalAmerican Journal of the Medical Sciences
Volume309
Issue number3
StatePublished - 1995

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Stem Cell Transplantation
Multiple Myeloma
Blood Cells
Melphalan
Whole-Body Irradiation
Transplants
Drug Therapy
Peripheral Blood Stem Cell Transplantation
Mucositis
Autologous Transplantation
Methylprednisolone
Chemoradiotherapy
Acute Kidney Injury
Cyclophosphamide
Leukemia
Radiotherapy
Stem Cells
Morbidity
Recurrence
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gertz, M., Pineda, A. A., Chen, M. G., Letendre, L., Greipp, P. R., Solberg, L. A., ... Noel, P. (1995). Refractory and relapsing multiple myeloma treated by blood stem cell transplantation. American Journal of the Medical Sciences, 309(3), 152-161.

Refractory and relapsing multiple myeloma treated by blood stem cell transplantation. / Gertz, Morie; Pineda, A. A.; Chen, M. G.; Letendre, L.; Greipp, P. R.; Solberg, L. A.; Witzig, Thomas Elmer; Garton, J. P.; Inwards, D. J.; Litzow, Mark R; Tefferi, Ayalew; Kyle, R. A.; Noel, P.

In: American Journal of the Medical Sciences, Vol. 309, No. 3, 1995, p. 152-161.

Research output: Contribution to journalArticle

Gertz, M, Pineda, AA, Chen, MG, Letendre, L, Greipp, PR, Solberg, LA, Witzig, TE, Garton, JP, Inwards, DJ, Litzow, MR, Tefferi, A, Kyle, RA & Noel, P 1995, 'Refractory and relapsing multiple myeloma treated by blood stem cell transplantation', American Journal of the Medical Sciences, vol. 309, no. 3, pp. 152-161.
Gertz, Morie ; Pineda, A. A. ; Chen, M. G. ; Letendre, L. ; Greipp, P. R. ; Solberg, L. A. ; Witzig, Thomas Elmer ; Garton, J. P. ; Inwards, D. J. ; Litzow, Mark R ; Tefferi, Ayalew ; Kyle, R. A. ; Noel, P. / Refractory and relapsing multiple myeloma treated by blood stem cell transplantation. In: American Journal of the Medical Sciences. 1995 ; Vol. 309, No. 3. pp. 152-161.
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