Autologous stem-cell transplantation in patients with multiple myeloma.
BACKGROUND
- Multiple myeloma is a malignant plasma-cell proliferative disorder, the second most common haematologic cancer. Treatment with high-dose therapy (HDT) and single autologous stem cell transplantation (ASCT) is a category I recommendation of the National Comprehensive Cancer Network. Double transplantation can be proposed for patients failing to achieve small a, Cyrillic very good partial response (VGPR) after a first ASCT. Aims - The aim of this study is to analyse the effect of treatment with high-dose chemotherapy and autologous stem-cell support on survival in patients with multiple myeloma, and to compare our results with the results from other transplant centres.


METHODS
- during a 7-year period we have performed 20 high-dose chemotherapy courses and autologous stem-cell transplantation on 17 patients (3 tandem transplantations) with multiple myeloma. In this trial we retrospectively analysed the epidemiology characteristics of these patients. Female: 9 Male - 8. Median age: 53 years (from 43-64 years).


RESULTS
diagnosis was made according to Salmon and Durie criteria. High-dose regimen consisted of Melphalan doses of 200mg/m2. In tandem transplantations the dose of the second high-dose regimen was 140 mg/m2. The volume of CD34+ cells was approximately 3.8 x 10exp8/Kg.bw. In 3 patients we used phlebothomy as a source of added stem cells. The period from diagnosis to transplantation was 12 months. Of 17 patients 70% are alive, 5 have died (3 renal failure, 1 fatal cerebral bleeding and 1 with multiorgan failure). The disease-free survival was 22 months in our group of patients. Overall survival was 48 months and survival after transplantation was 35 months. The probability of 7 years' overall survival exists in 50% of patients.


CONCLUSIONS
Patients treated with high-dose chemotherapy followed by autologous stem-cell support have a better survival and quality of life compared with patients treated with standard chemotherapy.
Stojanoski
Z
Z
Haematology Clinic, Medical Faculty, Ss Cyril and Methodius University, Skopje, R. Macedonia.
Georgievski
B
B
Cevreska
L
L
Stojanovic
A
A
Pivkova
A
A
Genadieva-Stavric
S
S
Stankovic
S
S
Karadzova-Stojanoska
A
A
D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000628:therapy*; D014182:Transplantation, Autologous
D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan