In pursuit of the graft-versus-myeloma effect: A single institution experience

Partly because of a potential graft-versus-myeloma effect, allogeneic stem cell transplantation is a potentially curative treatment modality in patients with multiple myeloma (MM). Initial attempts have been hampered by the high transplant-related mortality in this setting. With a reduction of toxic...

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Published inHematology (Luxembourg) Vol. 18; no. 2; pp. 89 - 92
Main Authors Galo-Hooker, Evelyn Gisella, Ruiz-Delgado, Guillermo José, Zamora-Ortiz, Gabriela, Velazquez-Sanchez-de-Cima, Sara, Ruiz-Arguelles, Guillermo José
Format Journal Article
LanguageEnglish
Published England Taylor & Francis 01.03.2013
Subjects
Adult
Allograft
Female
Graft vs Host Disease - diagnosis
Graft vs Host Disease - etiology
Graft vs Host Disease - mortality
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic Stem Cell Transplantation - methods
Humans
Male
Middle Aged
Multiple Myeloma - mortality
Multiple Myeloma - surgery
Myeloma
Reduced-intensity
Survival Analysis
Survival Rate
Time Factors
Transplant
Transplantation Conditioning - methods
Transplantation, Homologous
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Summary:Partly because of a potential graft-versus-myeloma effect, allogeneic stem cell transplantation is a potentially curative treatment modality in patients with multiple myeloma (MM). Initial attempts have been hampered by the high transplant-related mortality in this setting. With a reduction of toxicity, allogeneic transplant approaches with reduced-intensity conditioning (RIC) have been utilized, although they are subjected to continued disease progression and relapse following transplantation. We analyze here the experience of allografting four patients with MM in a single institution, along a 16-year period in which a total of 152 individuals were allografted, using an RIC regimen; three of the patients have had previous autografts. All patients engrafted successfully and a graft-versus-myeloma effect was shown in all of them. One patient relapsed in the face of graft-versus-host disease (GVHD). Three patients have died (two as a result of GVHD) and one is alive with a limited form of chronic GVHD. The graft-versus-myeloma effect can be induced by means of allogeneic transplantation but the morbidity and mortality associated with the procedure leads into a relatively small proportion of MM patients being cured.
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ISSN:1607-8454
1607-8454
DOI:10.1179/1607845412Y.0000000041