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Complete remission after myeloablation with bone-seeking 186Re-HEDP and high-dose melphalan followed by autologous stem cell transplantation in a patient with chemorefractory multiple myeloma

Bone Marrow Transplantation volume 36, pages 89–90 (2005)Cite this article

In 1993, a 54-year-old patient presented with stage IIIA myeloma (MM). After melphalan/prednisolone therapy, he achieved a plateau phase, but progressed in 1996 and PBSC were harvested after mobilization (cyclophosphamide/G-CSF). After conditioning with TMI (total marrow irradiation, 9 Gy), busulfan, and cyclophosphamide,1 autologous PBSC were transfused and complete remission was documented. Maintenance therapy (IFN-α) had to be discontinued due to intolerable side effects. The patient progressed again 11/1998, received four cycles of chemotherapy (vinorelbine, idarubicine, dexamethasone) and received high-dose melphalan followed by a second autologous PBSCT (partial remission).

Progression in 03/2000 did not respond to thalidomide, topotecan, high-dose dexamethasone/gemcitabine, and bendamustin had to be discontinued (allergic reaction). In 01/2001, the patient required weekly platelet and red blood cell transfusions. With no further conventional therapeutic options and no suitable HLA-matched donor, experimental therapy with 186Re-HEDP (rhenium-186 hydroxyethylidene diphosphonate) was initiated, followed by high-dose melphalan and a third autologous PBSCT.

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Acknowledgements

We gratefully appreciate the support of Dr Dorothea Alber, Hahn-Meitner-Institute, SF6, Berlin, who was responsible for the production of the 186Re used.

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Authors and Affiliations

  1. Department of Haematology, Oncology, Immunology and Rheumathology, Division of Medicine, University of Tuebingen, Germany

    A Wiesmann, H Einsele & L Kanz

  2. Department of Nuklearmedicine, University of Tuebingen, Germany

    B M Dohmen

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  1. A Wiesmann
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  2. H Einsele
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  3. L Kanz
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  4. B M Dohmen
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Wiesmann, A., Einsele, H., Kanz, L. et al. Complete remission after myeloablation with bone-seeking 186Re-HEDP and high-dose melphalan followed by autologous stem cell transplantation in a patient with chemorefractory multiple myeloma. Bone Marrow Transplant 36, 89–90 (2005). https://doi.org/10.1038/sj.bmt.1705002

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