title: In pursuit of the graft-versus-myeloma effect: a single institution experience.
abstract: Partly because of a potential graft-versus-myeloma effect, allogeneic stem cell transplantation is a potentially curative treatment modality in patients with multiple myeloma (MM). Initial attempts have been hampered by the high transplant-related mortality in this setting. With a reduction of toxicity, allogeneic transplant approaches with reduced-intensity conditioning (RIC) have been utilized, although they are subjected to continued disease progression and relapse following transplantation. We analyze here the experience of allografting four patients with MM in a single institution, along a 16-year period in which a total of 152 individuals were allografted, using an RIC regimen; three of the patients have had previous autografts. All patients engrafted successfully and a graft-versus-myeloma effect was shown in all of them. One patient relapsed in the face of graft-versus-host disease (GVHD). Three patients have died (two as a result of GVHD) and one is alive with a limited form of chronic GVHD. The graft-versus-myeloma effect can be induced by means of allogeneic transplantation but the morbidity and mortality associated with the procedure leads into a relatively small proportion of MM patients being cured.
authors: Centro de Hematologia y Medicina Interna, Clinica Ruiz, Puebla, Mexico.
authors: Evelyn Gisella
authors: EG
authors: Galo-Hooker
authors: Guillermo José
authors: GJ
authors: Ruiz-Delgado
authors: Gabriela
authors: G
authors: Zamora-Ortiz
authors: Sara
authors: S
authors: Velazquez-Sanchez-de-Cima
authors: Guillermo José
authors: GJ
authors: Ruiz-Arguelles
mesh_terms: D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous