[Autologous transplant (AT) with peripheral-blood stem-cell rescue for multiple myeloma. A clinical experience].
BACKGROUND
Multiple myeloma is rarely curable. Advances in high dose chemotherapy and stem cell transplantation have improved overall survival and event-free disease periods, but relapses are inevitable.


OBJECTIVE
To report our experience with AT in multiple myeloma, between 1994 and 2003.


METHODS
Retrospective analysis of 20 patients (12 women), with a mean age of 51.1 years. VAD (vincristine, doxorubicin and dexamethasone) was used as initial therapy in 19 patients. High dose cyclophosphamide (11 patients) and variations of VAD regimen (7) associated with granulocyte colony stimulating factor were used for peripheral-blood stem cell harvest. The conditioning regimen consisted of melphalan 200 mg/m2 followed by the reinfusion of peripheral-blood stem cells 24 hours later. The median number of CD34 cells infused was 3.3x10(6)/kg. Three patients were subjected to a second auto graft and one to a non-myeloablative transplant. Mean follow up was 35.5 months.


RESULTS
Mucositis and febrile neutropenia were common complications. The median number of days for neutrophil engraftment was 9 (range 8-11) and for platelets, 10 (range 7-13). No patient died. Complete remission was obtained in 60% (12/20), progression-free survival was 30 months and overall median survival, 47 months.


CONCLUSIONS
The AT with high-dose melphalan is a safe procedure in our hospital, without mortality and engraftment in all the patients. Complete remission and progression free survival were similar to those reported abroad but the overall median survival was lower.
Flores
Claudio
C
Sección Hematología y Banco de Sangre, Hospital Clínico, Universidad de Chile. cflores@redclinicauchile.cl
Conte
Guillermo
G
Fardella
Patricia
P
Araos
Daniel
D
Alfaro
Jorge
J
Aravena
Paola
P
González
Néstor
N
Larrondo
Milton
M
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor