High-Dose Chemoradiotherapy and Autologous Bone Marrow Transplantation for Resistant Multiple Myeloma

• Published in: Blood Vol. 70; no. 3; pp. 869 - 872
• Main Authors: Barlogie, Bart, Alexanian, Raymond, Dicke, Karel A., Zagars, Gunar, Spitzer, Gary, Jagannath, Sundar, Horwitz, Leonard
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 01.09.1987; The Americain Society of Hematology
• Subjects: Biological and medical sciences; Blood Cells - pathology; Bone Marrow Transplantation; Cell Count; Combined Modality Therapy; Humans; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunopathology; Medical sciences; Melphalan - administration & dosage; Melphalan - therapeutic use; Middle Aged; Multiple Myeloma - blood; Multiple Myeloma - drug therapy; Multiple Myeloma - radiotherapy; Multiple Myeloma - therapy; Human; Immunopathology; Autograft; Bone marrow; Various treatments; Advanced stage; Hemopathy; Myeloma; Chemoradiotherapy; High dose
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V70.3.869.869

Seven patients with advanced multiple myeloma, refractory to therapy with alkylating agent-VAD (vincristine-adriamycin-dexamethasone), received a regimen combining high-dose melphalan with total body irradiation supported by autologous bone marrow transplantation. Very rapid, usually >90% tumor mass reduction was achieved in six patients, regardless of prior chemotherapy responsiveness and marrow plasmacytosis up to 30%. Despite signs of early relapse in three patients (median remission duration of all patients, 15 months), five remain alive and well without further cytotoxic therapy from 2 to 21 months (median, 9+ months). Two patients died, one from surgical complications after transplantation and a second due to persistent neutropenia with fatal pneumonia. This treatment provides meaningful disease control for selected patients with resistant myeloma and a poor prognosis.© 1987 by Grune & Stratton, Inc. 0006-4971/87/7003-0033$3.00/0