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Darskaya et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract14
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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High-dose chemotherapy with autologous stem cell transplantation for multiple myeloma

Elena I. Darskaya, Igor A. Lisukov, Eleonora I. Podoltseva, Irina V. Kruchkova, Elena V. Babenko, Maria A. Estrina,  Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Pavlov State Medical University, Saint-Petersburg, Russia; Hospital 31, Saint- Petersburg, Russia; Institute of Clinical Immunology SB RAMS, Novosibirsk, Russia

Correspondence: Elena I. Darskaya, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint-Petersburg Pavlov State Medical University, 6/8, Tolstoy str., Saint-Petersburg, 197022, Russia, E-mail: edarskaya@spam is badspmu.rssi.ru

Abstract

Patients and methods: We analyzed the results of autologous stem cell transplantation (ASCT) in 167 patients with multiple myeloma from 1989 to 2010. The median age of patients was 52 years (range 25–62 years). High-dose melphalan (200 mg/m2, 180 mg/m2, 160 mg/m2) was used for conditioning.

Twelve MM patients received DexaBEAM followed by G-CSF and mobilization stem cells as part of high-dose programs including autologous transplantation, 19 patients received high-dose cyclophosphamide (4 g/m2), and 4 patients received the EDAP protocol. The VAD protocol as induction therapy was used with 59 patients, PAD or VD was used with 24 patients, idarubicin+ dexamethason with 5 patients, and 79 patients before 2000 received other regimens (M2, MP).

Results: Overall survival at 60 months was 58% in the patients who underwent one autologous stem cell transplantation and had a chemo-sensitive disease before transplant. Overall survival at 60 months with the patients who had no chemosensitive disease (stable disease or progressive disease before one ASCT) was 0. Three-year event-free survival was better for the patients who achieved their response at induction therapy compared to the patients who achieved a response later: 58% vs. 18%, respectively (p=0.004).
Ten-year overall survival after double-ASCT was 55%, 10-year OS after one ASCT was 46%.

The second ASCT did not improve OS in the patients who achieved a response before one ASCT: 10-year OS after one ASCT was 50%, and after double ASCT, 51%. However, 5-year EFS was better with patients after double ASCT compared to one ASCT: 30 % vs. 18% respectively. A second ASCT improves OS for patients who had no response before one ASCT: 5-year OS was 75% after double ASCT and 0% after one ASCT.

We describe the long-term outcome of the patients who underwent ASCT in 1989–2000 and 2000–2010.

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

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