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An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
A simplified method for stem cell autografting in multiple myeloma: a single institution experience
A López-Otero1, G J Ruiz-Delgado, G J Ruiz-Argüelles
1Centro de Hematología y Medicina Interna de Puebla, Clinica Ruiz de Puebla, 8B Sur 3710, Colonia Anzures, Puebla, Mexico.
Abstract:
In a 14-year period in a single institution 31 autografts were performed in 26 patients with multiple myeloma (MM), using a simplified and affordable autografting procedure: conducting the grafts on an outpatient basis and avoiding stem cell freezing. Autografts were started on an outpatient basis in all instances, but four patients were admitted to the hospital. Median time to achieve more than 0.5 x 10(9)/l granulocytes was 27 days, whereas median time to recover above 20 x 10(9)/l plts was 37 days. CR was achieved in 19 cases and a very good partial response in 6 cases. The 100-day mortality was 9.6%. The overall median post-transplant survival has not been reached, being above 76 months, whereas the 76-month survival is 80%. The median cost of each procedure was US$ 15 000. Survival results were substantially better than those of historical control in a group of patients treated in the same institution with melphalan/prednisone. It is concluded that high-dose therapy rescued with a simplified autologous stem cell graft is a valid, useful and affordable therapeutic option for patients with MM, even with economical restraints.
Insights
This study shows that a simplified, outpatient autologous stem cell transplant procedure for multiple myeloma (MM) is effective and affordable. This approach offers improved survival outcomes compared to historical treatments, making it a viable option for MM patients.
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.
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