Long-term follow up of patients with multiple myeloma after high-dose chemotherapy and allogeneic stem cell transplantation

Eur J Haematol. 2004 Jan;72(1):26-31. doi: 10.1046/j.0902-4441.2004.00178.x.

Abstract

Objectives: Allogeneic transplantation may offer a curative approach to multiple myeloma (MM). We retrospectively analyzed the outcome of patients with multiple myeloma undergoing allogeneic stem cell transplantation in the context of beta(2) microglobulin and chromosome 13q.

Methods: All 13 patients with MM, who were referred to our center for allogeneic stem cell transplantation, were evaluated. Median age of patients was 38 yr, eight patients had chemo-sensitive disease, and median time between diagnosis of MM and transplantation was 15 months. Engraftment, acute and chronic graft vs. host disease, response to treatment, disease-free survival, and overall survival were evaluated according to standard criteria.

Results: There was one transplant-related death. Among 12 evaluable patients, seven patients (58%) achieved a complete remission (CR), and four patients (33%) achieved a partial remission. Acute graft vs. host disease occurred in 46% of patients, and chronic graft vs. host disease in 42% of available patients. After a median follow-up of 69.5 months (range, 5-128) nine patients (70%) are still alive, and six of them have remained progression free. Among five patients with low beta(2) microglobulin and normal chromosome 13q, four patients achieved a CR, with CR duration >5 yr in three of them. Among seven patients with elevated ss(2) microglobulin and/or deletion of chromosome 13q, only three CR were observed, with two patients still in CR on days +920 and +161, respectively.

Conclusions: Allogeneic stem cell transplantation in patients with MM results in promising rates of CR, but durable remissions are predominantly seen in patients with favorable prognostic parameters.

MeSH terms

  • Adult
  • Combined Modality Therapy
  • Cyclophosphamide / therapeutic use
  • Disease-Free Survival
  • Female
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Living Donors
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / mortality
  • Multiple Myeloma / pathology
  • Multiple Myeloma / therapy*
  • Neoplasm Staging
  • Retrospective Studies
  • Stem Cell Transplantation*
  • Survival Rate
  • Transplantation Conditioning / methods
  • Transplantation, Homologous
  • Whole-Body Irradiation

Substances

  • Immunosuppressive Agents
  • Cyclophosphamide