Autotransplants in multiple myeloma: what have we learned?

摘要: Of 496 consecutive patients with multiple myeloma (MM) enrolled in clinical trials of tandem transplants peripheral blood stem cells support, 470 (95%) completed the first autotransplant melphalan 200 mg/m2 (MEL 200) and 363 (73%) second transplant either MEL (40%), 140 140) total-body irradiation (17%), or a combination alkylating agents (16%), depending on response status prior to transplant; 31 up age 60 years received an allograft as transplant. The median interval from was 5 months. Treatment-related mortality during year after transplantation 7%, complete remission (CR) obtained 36%; durations event-free survival (EFS) overall (OS) were 26 41 months, respectively. Low beta 2-microglobulin ([B2M] < = 2.5 mg/L) C-reactive protein ([CRP] 0.4 mg/dL) most significant standard parameters associated both prolonged EFS OS. Median OS exceeded 5.5 one third low B2M CRP. When cytogenetics included analysis, presence 11q abnormalities and/or partial deletion chromosome 13 (“unfavorable karyotype”) became dominant negative feature for In addition these pretransplant parameters, attainment CR application two within 6 months significantly extended group (7%) high CRP IgA isotype unfavorable karyotype had worst prognosis (EFS, 10 months; OS, 12 months) will require novel therapy. We conclude that are feasible majority 70 years, effecting all patients. greater than regardless features, if applied initial treatment no more later.