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Related Experiment Videos

Bone marrow transplantation in multiple myeloma.

B Barlogie1, G Gahrton

  • 1Division of Hematology/Oncology, University of Arkansas for Medical Sciences, Little Rock 72205.

Bone Marrow Transplantation
|February 1, 1991
PubMed
Summary

High-dose chemotherapy with stem cell support shows promise for multiple myeloma patients. This approach, particularly autologous transplantation for low tumor burden, offers improved complete remission rates and survival, even in older adults.

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Area of Science:

  • Hematology
  • Oncology
  • Transplantation Medicine

Background:

  • Standard melphalan and prednisone therapies offer limited improvement for multiple myeloma patients.
  • High-dose melphalan and stem cell support have emerged as a promising alternative.

Purpose of the Study:

  • To evaluate the efficacy and safety of marrow-ablative therapy with hemopoietic stem cell support in multiple myeloma.
  • To provide recommendations for allogeneic and autologous transplantation strategies.

Main Methods:

  • Review of experience in approximately 400 patients with advanced and refractory multiple myeloma.
  • Analysis of outcomes based on stem cell source (allogeneic/autologous, bone marrow/blood) and preparative regimens.

Main Results:

  • Partial remissions achieved in nearly all patients; complete remissions (CR) in less than half.
  • Allogeneic BMT: <30% mortality, 40% CR, 70% 3-year relapse-free survival in patients <50.
  • Autologous transplantation: <10% mortality, >30% CR, >80% 3-year survival if performed with low tumor burden.

Conclusions:

  • Hemopoietic stem cell grafting is a viable treatment strategy for multiple myeloma, including older patients.
  • Autologous transplantation is most effective when initiated with low tumor burden and standard therapy efficacy.
  • Consider stem cell grafting to prevent irreversible stem cell damage from other treatments.

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