The use of an expanded circulating hematopoietic progenitor cell pool associated with bone marrow fibrosis for the support of autologous transplantation in IgD multiple myeloma

Abstract

Leukoerythroblastosis and myelofibrosis were observed at presentation in a patient with IgD myeloma. Interestingly, a 1000-fold increase in peripheral blood progenitor cells (PBPC) was found in the steady state without signs of any underlying myeloproliferative disorder. The myeloma was resistant to conventional therapy. The expanded PBPC were collected in the steady state and used to support two consecutive myeloablative courses. A complete remission of the myeloma was achieved, with resolution of myelofibrosis. Furthermore, the unprimed PBPC expanded as a result of myelofibrosis, provided a sustained hematopoietic reconstitution. This indicated that their hematopoietic potential was equivalent to that of PBPC mobilized by chemotherapy or growth factors.