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Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma.
Bone Marrow Transplant. 1999 Feb; 23(3):221-6.BM

Abstract

Transplantation after high-dose chemotherapy prolongs survival in patients with multiple myeloma compared with standard therapy. It is unclear whether the optimal timing of transplantation is immediately after induction chemotherapy or whether stem cells may be cryopreserved for transplantation at subsequent progression or relapse. In this study, stem cells were collected within 6 months of diagnosis, followed by transplantation only at progression of myeloma. One hundred and eighteen patients with multiple myeloma had stem cells collected and cryopreserved. Eleven had transplants early in the disease after they demonstrated failure to respond to primary therapy. The remaining 107 were eligible for transplants when there was evidence of progressive disease. Of the 118 patients, 67 had transplants, nine died of progressive disease before transplantation, and 42 remain alive in plateau phase. The median survival of the group is 58.5 months; 67 are alive. Serum beta2-microglobulin, bone marrow labeling index (S phase), and hemoglobin level predicted overall survival (P < 0.006, P < 0.001, and P < 0.01, respectively). We conclude that early cryopreservation of blood stem cells followed by transplantation at progression is a feasible approach to therapy in patients with myeloma. The underlying biology of the disease has a greater impact on survival than the timing of transplantation. A prospective randomized trial is required to answer definitively the question of the optimal timing of blood cell transplantation.

Authors+Show Affiliations

Division of Hematology and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10084252

Citation

Gertz, M A., et al. "Early Harvest and Late Transplantation as an Effective Therapeutic Strategy in Multiple Myeloma." Bone Marrow Transplantation, vol. 23, no. 3, 1999, pp. 221-6.
Gertz MA, Lacy MQ, Inwards DJ, et al. Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma. Bone Marrow Transplant. 1999;23(3):221-6.
Gertz, M. A., Lacy, M. Q., Inwards, D. J., Chen, M. G., Pineda, A. A., Gastineau, D. A., Greipp, P. R., Lust, J. A., Tefferi, A., Witzig, T. E., Kyle, R. A., & Litzow, M. R. (1999). Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma. Bone Marrow Transplantation, 23(3), 221-6.
Gertz MA, et al. Early Harvest and Late Transplantation as an Effective Therapeutic Strategy in Multiple Myeloma. Bone Marrow Transplant. 1999;23(3):221-6. PubMed PMID: 10084252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early harvest and late transplantation as an effective therapeutic strategy in multiple myeloma. AU - Gertz,M A, AU - Lacy,M Q, AU - Inwards,D J, AU - Chen,M G, AU - Pineda,A A, AU - Gastineau,D A, AU - Greipp,P R, AU - Lust,J A, AU - Tefferi,A, AU - Witzig,T E, AU - Kyle,R A, AU - Litzow,M R, PY - 1999/3/20/pubmed PY - 1999/3/20/medline PY - 1999/3/20/entrez SP - 221 EP - 6 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 23 IS - 3 N2 - Transplantation after high-dose chemotherapy prolongs survival in patients with multiple myeloma compared with standard therapy. It is unclear whether the optimal timing of transplantation is immediately after induction chemotherapy or whether stem cells may be cryopreserved for transplantation at subsequent progression or relapse. In this study, stem cells were collected within 6 months of diagnosis, followed by transplantation only at progression of myeloma. One hundred and eighteen patients with multiple myeloma had stem cells collected and cryopreserved. Eleven had transplants early in the disease after they demonstrated failure to respond to primary therapy. The remaining 107 were eligible for transplants when there was evidence of progressive disease. Of the 118 patients, 67 had transplants, nine died of progressive disease before transplantation, and 42 remain alive in plateau phase. The median survival of the group is 58.5 months; 67 are alive. Serum beta2-microglobulin, bone marrow labeling index (S phase), and hemoglobin level predicted overall survival (P < 0.006, P < 0.001, and P < 0.01, respectively). We conclude that early cryopreservation of blood stem cells followed by transplantation at progression is a feasible approach to therapy in patients with myeloma. The underlying biology of the disease has a greater impact on survival than the timing of transplantation. A prospective randomized trial is required to answer definitively the question of the optimal timing of blood cell transplantation. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/10084252/Early_harvest_and_late_transplantation_as_an_effective_therapeutic_strategy_in_multiple_myeloma_ L2 - https://doi.org/10.1038/sj.bmt.1701559 DB - PRIME DP - Unbound Medicine ER -