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Tangen (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract17
© 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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The effectiveness of second high dose melphalan with autologous stem cell support in relapsed myeloma patients

Jon-Magnus Tangen

Department of Hematology, Ulleval University Hospital, Oslo, Norway

Correspondence: Jon-Magnus Tangen,  Department of Hematology, Ulleval University Hospital, 0407 Oslo, Norway, E-mail: Jon.Magnus.Tangen@spam is badoslo-universitetssykehus.no

Abstract

High dose melphalan with autologous stem cell support (HDM) is the recommended first-line treatment for patients <65 years with multiple myeloma. However, there is no consensus regarding the optimal relapse treatment after HDM (second HDM, thalidomide, bortezomide, lenalidomide, others). In the Department of Hematology, Ulleval University Hospital, Oslo, a second HDM is recommended for myeloma patients <65 years relapsing 12 months or later after the first HDM. This presentation summarizes our experience with this treatment. 

In the period 2005–2009, a second HDM was found to be indicated in 18 relapsing myeloma patients (Male/Female 10/8, median age at diagnosis:  49 years (range: 36–59 years)). Median time to relapse was 36 months (range: 13–103 months). Two patients did not receive the assigned treatment due to a failed stem cell harvest. In the remaining patients, a second stem cell harvest was performed in four cases. For twelve patients stored stem cells were available from the first harvest. There was no treatment-related mortality. None of the patients were treated in an intensive care unit. All patients responded to the treatment. The calculated cost of the second HDM was in the range between Eur 15,000 and Eur 25,000, depending on the type of induction treatment, availability of stem cells, and length of hospital stay. Median time to progression after a second HDM was 17 months (6–25 months). Median overall survival for the patients receiving a second HDM was 68 months.

Conclusion:
Treatment with a second HDM in myeloma patients relapsing after first line HDM is feasible and effective. The toxicity and costs are moderate.  
 
Keywords:
multiple myeloma, relapse, second high dose melphalan, autologous stem cell support

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