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ctt-journal > Mendeleeva et al. (Abstract)

Mendeleeva et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract18

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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The efficacy and safety of high-dose therapy and autologous stem cell transplantation for patients with multiple myeloma

Larisa P. Mendeleeva, Olga S. Pokrovskaya, Inna V. Alekseeva, Evdokiya S. Urnova, Tatiana V. Gaponova, Larisa A. Kuzmina, Elena O. Gribanova, Elena N. Parovichnikova, Valeriy G. Savchenko

Research Centre for Hematology of Ministry of Health and Social Development of Russian Federation, Moscow, Russia

Correspondence: Olga S Pokrovskaya, Research Center for Hematology of Ministry of Health and Social Development of Russian Federation; Novozykovski proezd, 4, 125167, Moscow, Russia, E-mail: sillywilly@spam is badyandex.ru

Abstract

Introduction: High-dose melphalan followed by ASCT is widely used as a consolidation treatment in patients with multiple myeloma (MM) younger than 65 years.

Aim: To evaluate HDT and ASCT efficacy and long-term outcomes of MM patients treated in the department of High-dose Chemotherapy and Bone Marrow Transplantation.

Methods: From June 2000 to June 2011, 104 pts with MM (55 male, 49 female), median age 52.5 (range 29–68) underwent ASCT. The pts received VAD chemotherapy and/or bortezomib + dexamethasone +/- doxorubicin +/- cyclophosphamide as induction. In the mobilization procedure pts received cyclophosphamide 4–6 g/m2 followed by the daily administration of G-CSF at 5 µg/kg. HDT/ASCT entailed conditioning with melphalan at 200 mg/m2. Response was defined according to IMWG criteria.

Results: After the induction treatment 56 (53.8%) pts were in CR and VGPR. During mobilization a median of 17.4x106 CD34+ cells/kg were collected (range 2.06–106 x106). The median number of apheresis was 2 (1–6). Early transplant-related mortality was 0.96%, and one patient died of infectious complications. The OS at the 7-year follow-up was 71.4%. PFS at 5-year was 43.7%, at 7-year 19%. 87 pts (83.6%) are still alive.

The pts in CR/VGPR before ASCT had significantly longer OS and PFS compared with those in PR (p=0.05 and p=0.001). In pts with CR/VGPR OS at 5-y was 78%, and PFS at 5-y was 60%; and in PR or stable disease 5-y OS was 65% and 5-y PFS 20%. CR/VGPR after ASCT also predicted longer PFS; however there was no significant difference in PFS in pts with continued CR/VGPR after ASCT and in pts with induced CR/VGPR after ASCT who were in PR before ASCT.

Conclusion: HDT and ASCT is a safe and well-tolerated method of treatment for pts with MM, providing long-term survival. Better OS and PFS were observed in pts who achieved CR/VGPR.

Keywords: multiple myeloma, high-dose therapy, autologous transplantation