A simplified method for stem cell autografting in multiple myeloma: a single institution experience

Area of Science:

• Hematology
• Oncology
• Transplant Medicine

Background:

• Multiple myeloma (MM) treatment often involves high-dose therapy.
• Autologous stem cell transplantation (ASCT) is a key component of MM treatment.
• Traditional ASCT can be resource-intensive, involving hospitalization and stem cell cryopreservation.

Purpose of the Study:

• To evaluate a simplified, affordable autologous stem cell grafting procedure for multiple myeloma.
• To assess the feasibility and outcomes of outpatient ASCT without stem cell freezing.
• To compare survival results with historical control groups.

Main Methods:

• A 14-year retrospective analysis of 31 ASCTs in 26 MM patients.
• Procedure conducted on an outpatient basis, avoiding stem cell freezing.
• Monitoring of hematopoietic recovery (granulocytes and platelets).

Main Results:

• Median granulocyte recovery: 27 days; median platelet recovery: 37 days.
• Complete response (CR) in 19 patients; very good partial response in 6.
• 100-day mortality: 9.6%; 76-month survival: 80%.
• Median procedure cost: US$15,000.
• Survival outcomes superior to historical melphalan/prednisone treatment.

Conclusions:

• Simplified, outpatient ASCT is a valid, useful, and affordable therapeutic option for MM.
• This approach improves survival and is cost-effective, even with economic constraints.
• High-dose therapy with simplified ASCT offers a promising treatment strategy for MM patients.