title: Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma.
abstract: This report describes the clinical characteristics, treatment associated toxicity, and follow-up of fifty-eight patients with plasma cell--dyscrasias treated with high dose chemotherapy and total body irradiation (TBI) at a single institution. Following TBI, 36 patients received anti-B cell monoclonal antibody (MoAb)-treated autologous bone marrow, 21 patients received anti-CD6 cell MoAb-treated allogeneic bone marrow to deplete T cells, and one patient received unpurged bone marrow from a syngeneic donor. Evaluation after high dose chemotherapy and bone marrow transplantation (BMT) demonstrated 26 complete responses (CR), 26 partial responses (PR), 2 non-responders, 1 not yet evaluated, and three toxic deaths. Fourteen of 36 patients who underwent autologous BMT are alive free from progression at 18 (range 5 to 68) months post transplant (post-BMT); of these, 11 remain in continuous complete response at 16 (range 5 to 68) months post-BMT. Seven of 21 patients who underwent allogeneic BMT are alive free from progression at 30 (range 4 to 44) months post-BMT; of these, three patients remain in continuous complete response at 43 (range 33 to 45) months post-BMT. These data suggest that high dose chemotherapy with TBI followed by MoAb purged BM can be performed with acceptable toxicity and high tumor response rates.
authors.affiliation: Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
authors.forename: M V
authors.initials: MV
authors.lastname: Seiden
authors.forename: R
authors.initials: R
authors.lastname: Schlossman
authors.forename: J
authors.initials: J
authors.lastname: Andersen
authors.forename: A
authors.initials: A
authors.lastname: Freeman
authors.forename: M
authors.initials: M
authors.lastname: Robertson
authors.forename: R
authors.initials: R
authors.lastname: Soiffer
authors.forename: A
authors.initials: A
authors.lastname: Freedman
authors.forename: P
authors.initials: P
authors.lastname: Mauch
authors.forename: J
authors.initials: J
authors.lastname: Ritz
authors.forename: L
authors.initials: L
authors.lastname: Nadler
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000473:pathology; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D014916:Whole-Body Irradiation
chemical_list: D000911:Antibodies, Monoclonal; D003520:Cyclophosphamide; D008558:Melphalan