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Autografting

Autologous stem cell transplantation followed by consolidation chemotherapy for patients with multiple myeloma

Bone Marrow Transplantation volume 37, pages 65–72 (2006)Cite this article

Abstract

Although high-dose therapy and autologous stem cell transplant (ASCT) is superior to conventional chemotherapy for treatment of myeloma, most patients relapse and the time to relapse depends upon the initial prognostic factors. The administration of non-cross-resistant chemotherapies during the post-transplant period may delay or prevent relapse. We prospectively studied the role of consolidation chemotherapy (CC) after single autologous peripheral blood stem cell transplant (auto-PBSCT) in 103 mostly newly diagnosed myeloma patients (67 patients were ⩽6 months from the initial treatment). Patients received conditioning with BCNU, melphalan±gemcitabine and auto-PBSCT followed by two cycles of the DCEP±G regimen (dexamethasone, cyclophosphamide, etoposide, cisplatin±gemcitabine) at 3 and 9 months post-transplant and alternating with two cycles of DPP regimen (dexamethasone, cisplatin, paclitaxel) at 6 and 12 months post-transplant. With a median follow-up of 61.2 months, the median event-free survival (EFS) and overall survival (OS) are 26 and 54.1 months, respectively. The 5-year EFS and OS are 23.1 and 42.5%, respectively. Overall, 51 (49.5%) patients finished all CC, suggesting that a major limitation of this approach is an inability to deliver all planned treatments. In order to improve results following autotransplantation, novel agents or immunologic approaches should be studied in the post-transplant setting.

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Acknowledgements

We thank the nurses of the BMT unit for outstanding patient care. APR is a Clinical Scholar of the Leukemia and Lymphoma Society.

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Author notes

  1. G Tricot and A P Rapoport: These authors contributed equally to this work.

Authors and Affiliations

  1. Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA

    I Gojo, B Meisenberg, C Guo, A Murthy, R Fenton, N Takebe, M Heyman, K Ruehle, T French, M Tan & A P Rapoport

  2. University of Arkansas, Myeloma Institute for Research and Therapy, Little Rock, AR, USA

    A Fassas, M Cottler-Fox & G Tricot

  3. University of Rochester, Wilmot Cancer Center, Rochester, NY, USA

    G L Philips

  4. City of Hope Samaritan BMT Program, Phoenix, AZ, USA

    C Sarkodee-Adoo

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Correspondence to I Gojo.

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Gojo, I., Meisenberg, B., Guo, C. et al. Autologous stem cell transplantation followed by consolidation chemotherapy for patients with multiple myeloma. Bone Marrow Transplant 37, 65–72 (2006). https://doi.org/10.1038/sj.bmt.1705192

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  • DOI: https://doi.org/10.1038/sj.bmt.1705192

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