Abstract
A total of 30 multiple myeloma patients (M = 23, F = 7; age 31-55 years, median 48) were allografted with peripheral blood stem cells (PBSC) from HLA-identical siblings. Time to transplantation was 3-107 months (median 8). Prior chemotherapy lines varied from 1 to 6 (median 1). Four patients were in complete remission (CR), 11 in partial remission (PR), 13 were considered to be nonresponders, and two had progressive disease. Most were conditioned with busulfan-melphalan. PBSC were collected by apheresis after G-CSF or sequential GM-CSF and G-CSF. The patients were grafted with 4.4-24.1 × 106/kg CD34+ (median 7.9) and 0.9-7.9 × 108/kg CD3+ cells (median 2.3). GVHD prophylaxis was methotrexate-cyclosporine. Engraftment was complete and rapid. Grades II-IV acute GVHD (aGVHD) developed in 16 (53% , but was grade III-IV only in five (17%); chronic GVHD (cGVHD) developed in 17 out of the 24 evaluable patients (71%). A total of 18 patients (71%) attained CR after transplantation. TRM was 30% overall, 16% at 100 days. There was only one relapse. Overall survival and event-free survival at 73 months were 60% and 67%, respectively. PCR negativity for IgH-gene rearrangement occurred in all persistently CR patients studied. PBSC allograft can induce long remissions, because of profound suppression of the neoplastic clone that is probably linked to the antitumor effect of cGVHD.
| Original language | English |
|---|---|
| Pages (from-to) | 767-773 |
| Number of pages | 7 |
| Journal | Bone Marrow Transplantation |
| Volume | 31 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - May 2003 |
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Keywords
- Allogeneic
- GVHD
- Myeloma
- PBSC
- Transplantation
ASJC Scopus subject areas
- Hematology
- Transplantation
Cite this
High rate of remission and low rate of disease recurrence in patients with multiple myeloma allografted with PBSC from their HLA-identical sibling donors. / Majolino, I.; Corradini, P.; Scimè, R.; Falda, M.; Bosi, A.; Tarella, C.; Musso, M.; Olivieri, A.; Boccadoro, M.; Marcenò, R.; Santoro, A.; Pileri, A.
In: Bone Marrow Transplantation, Vol. 31, No. 9, 05.2003, p. 767-773.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High rate of remission and low rate of disease recurrence in patients with multiple myeloma allografted with PBSC from their HLA-identical sibling donors
AU - Majolino, I.
AU - Corradini, P.
AU - Scimè, R.
AU - Falda, M.
AU - Bosi, A.
AU - Tarella, C.
AU - Musso, M.
AU - Olivieri, A.
AU - Boccadoro, M.
AU - Marcenò, R.
AU - Santoro, A.
AU - Pileri, A.
PY - 2003/5
Y1 - 2003/5
N2 - A total of 30 multiple myeloma patients (M = 23, F = 7; age 31-55 years, median 48) were allografted with peripheral blood stem cells (PBSC) from HLA-identical siblings. Time to transplantation was 3-107 months (median 8). Prior chemotherapy lines varied from 1 to 6 (median 1). Four patients were in complete remission (CR), 11 in partial remission (PR), 13 were considered to be nonresponders, and two had progressive disease. Most were conditioned with busulfan-melphalan. PBSC were collected by apheresis after G-CSF or sequential GM-CSF and G-CSF. The patients were grafted with 4.4-24.1 × 106/kg CD34+ (median 7.9) and 0.9-7.9 × 108/kg CD3+ cells (median 2.3). GVHD prophylaxis was methotrexate-cyclosporine. Engraftment was complete and rapid. Grades II-IV acute GVHD (aGVHD) developed in 16 (53% , but was grade III-IV only in five (17%); chronic GVHD (cGVHD) developed in 17 out of the 24 evaluable patients (71%). A total of 18 patients (71%) attained CR after transplantation. TRM was 30% overall, 16% at 100 days. There was only one relapse. Overall survival and event-free survival at 73 months were 60% and 67%, respectively. PCR negativity for IgH-gene rearrangement occurred in all persistently CR patients studied. PBSC allograft can induce long remissions, because of profound suppression of the neoplastic clone that is probably linked to the antitumor effect of cGVHD.
AB - A total of 30 multiple myeloma patients (M = 23, F = 7; age 31-55 years, median 48) were allografted with peripheral blood stem cells (PBSC) from HLA-identical siblings. Time to transplantation was 3-107 months (median 8). Prior chemotherapy lines varied from 1 to 6 (median 1). Four patients were in complete remission (CR), 11 in partial remission (PR), 13 were considered to be nonresponders, and two had progressive disease. Most were conditioned with busulfan-melphalan. PBSC were collected by apheresis after G-CSF or sequential GM-CSF and G-CSF. The patients were grafted with 4.4-24.1 × 106/kg CD34+ (median 7.9) and 0.9-7.9 × 108/kg CD3+ cells (median 2.3). GVHD prophylaxis was methotrexate-cyclosporine. Engraftment was complete and rapid. Grades II-IV acute GVHD (aGVHD) developed in 16 (53% , but was grade III-IV only in five (17%); chronic GVHD (cGVHD) developed in 17 out of the 24 evaluable patients (71%). A total of 18 patients (71%) attained CR after transplantation. TRM was 30% overall, 16% at 100 days. There was only one relapse. Overall survival and event-free survival at 73 months were 60% and 67%, respectively. PCR negativity for IgH-gene rearrangement occurred in all persistently CR patients studied. PBSC allograft can induce long remissions, because of profound suppression of the neoplastic clone that is probably linked to the antitumor effect of cGVHD.
KW - Allogeneic
KW - GVHD
KW - Myeloma
KW - PBSC
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=10744220917&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=10744220917&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1703924
DO - 10.1038/sj.bmt.1703924
M3 - Article
C2 - 12732883
AN - SCOPUS:10744220917
VL - 31
SP - 767
EP - 773
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 9
ER -