Autologous bone marrow transplantation therapy for multiple myeloma.
We have begun an autologous bone marrow transplantation (ABMT) treatment protocol for patients with myeloma who achieve a minimal disease (less than 10% marrow plasma cells) status. Sites of bony disease are irradiated before BMT. Melphalan 70 mg/m2 on days 1 and 2 is followed by 1200 rads total-body irradiation administered in fractionated doses over 3 d. Autologous marrow which has been previously treated with anti-CALLA, B1, and PCA-1 monoclonal antibodies is then thawed and reinfused. 4 males and 2 females with median age of 46 yr (41-56) have been treated. Granulocytes greater than 500/mm3 and platelets greater than 20,000/mm3 were noted at 21 (12-46) and 23 (12-53) d post-transplant (PT), respectively. Acute mucositis and dermatomal Herpes zoster developed in 3 patients each; all patients are clinically well at 233 (30-807) d PT. All patients achieved pathologically normal marrows, but monoclonal plasma cells and marrow myelofibrosis were each noted in a single patient at 486 and 272 d PT, respectively. A single patient has responded to alpha 2 interferon therapy PT; all others have received no therapy. AMBT offers an exciting new treatment for myeloma; however, relapses post-ABMT suggest that improved ablative regimens and/or marrow purging methods may be required.
Anderson
K C
KC
Barut
B A
BA
Ritz
J
J
Freedman
A S
AS
Nadler
L M
LM
D000328:Adult; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D009194:Myeloma Proteins / Q000032:analysis; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
D007370:Interferon Type I; D009194:Myeloma Proteins; D008558:Melphalan