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Molecular remission of multiple myeloma with cytoreductive autografting followed by a dose-reduced allograft

Bone Marrow Transplantation volume 40, pages 997–999 (2007)Cite this article

High-dose chemotherapy with rescue of autologous PBSC (auto-PBSCT) is regarded as the standard of care for newly diagnosed multiple myeloma (MM) in patients under 65 years of age.1, 2 Recently, new drugs such as thalidomide or bortezomib have been introduced for myeloma treatment and the overall survival of MM patients has been improving.3 However, the prognosis of patients with refractory or relapsed MM is still poor. Allogeneic SCT (allo-SCT) is the only potentially curative treatment for MM but it is associated with high treatment-related mortality (TRM). A total of 30–50% of patients who survive the first year remain disease-free at 3–6 years. Such durable remissions have been attributed to a graft-versus-myeloma (GVM) effect. Non-myeloablative or dose-reduced allograft (mini-allograft) has recently been explored as a safer alternative to conventional high-dose transplant regimens.4 Auto-PBSCT followed by mini-allograft was superior to tandem autologous transplantation in terms of survival.5 Molecular monitoring of minimal residual disease (MRD) is important for evaluating patients after allo-SCT,6 but there is no report on MRD monitoring after the tandem auto-allo approach. Herein, we report the results on high-risk myeloma patients who underwent tandem auto-mini-allograft. Subsequent MRD detection was carried out using allele-specific oligonucleotide (ASO) primers.

Patients with MM under 65 years old, who failed to achieve CR with conventional chemotherapy or relapsed, and who had an HLA-identical sibling donor, were eligible. Between April 2000 and April 2006 10 patients were enrolled, but PBSC could not be harvested from two patients and they received only mini-allografts; therefore, 8 patients (age: median, 49.5 years; range, 36–53 years) were analyzed (Table 1).

Table 1 Characteristics of the patients and results of auto-PBSCT followed by dose-reduced allograft
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Figure 1

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Authors and Affiliations

  1. Division of Hematology, Department of Clinical Cell Biology, Chiba University Graduate School of Medicine, Chiba, Japan

    K Fujikawa, C Nakaseko, R Cho, D Abe, K Oda, H Tanaka, C Ohwada, S Ozawa, M Takeuchi, E Sakaida, N Shimizu, M Naito, M Nishimura & Y Saito

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  1. K Fujikawa
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  2. C Nakaseko
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  3. R Cho
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  4. D Abe
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  7. C Ohwada
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  8. S Ozawa
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  11. N Shimizu
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  12. M Naito
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  13. M Nishimura
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  14. Y Saito
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Correspondence to C Nakaseko.

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Fujikawa, K., Nakaseko, C., Cho, R. et al. Molecular remission of multiple myeloma with cytoreductive autografting followed by a dose-reduced allograft. Bone Marrow Transplant 40, 997–999 (2007). https://doi.org/10.1038/sj.bmt.1705843

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