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Allogeneic stem cell transplantations in multiple myeloma patients – single center experience


Authors: S. Vokurka;  V. Koza;  P. Jindra;  M. Karas;  K. Steinerová;  D. Lysák;  M. Schutzova;  T. Svoboda;  V. Vozobulová;  M. Švojgrová;  L. Mohammadová;  A. Jungová;  M. Hrabětová
Authors‘ workplace: Hematologicko-onkologické oddělení, Fakultní nemocnice Plzeň
Published in: Transfuze Hematol. dnes,15, 2009, No. 4, p. 244-250.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Regardless of its curative potential, the role and indications of the allogeneic stem cell transplantation (SCT) in multiple myeloma remain an issue of discussions. Because of high mortality, morbidity and relapse rate, the allogeneic SCT with myeloablative or reduced-intensity conditioning regimen is not considered a standard treatment approach. The retrospective analysis of our cohort of transplanted patients verified the unacceptable mortality within the conventional conditioning regimen Bu/CY2 (n = 4). In the group of 14 patients after SCT with reduced intensity conditioning regimen FLU/MEL (fludarabine, melphalan), there was the overall response rate of 93% with 43% complete remissions, the transplantation related mortality (TRM) 21%, probability of the 2-year and 4-year progression free survival (PFS) 34% and 17% and the 5-year overall survival (OS) 47%. Better results were observed in patients transplanted without progressive or minimal responding disease. Performing the allogeneic SCT did not limit future treatment of myeloma progressions with the use of bortezomib or thalidomide. Our results are in concordance with those published by other authors. Allogeneic SCT should be performed according to defined protocols and in the frame of multicentre clinical and laboratory cooperation, if possible. The potential of combining the allogeneic SCT with bortezomib, thalidomide or lenalidomide treatment is a challenge for future research.

Key words:
multiple myeloma, allogeneic transplantation, bortezomib, thalidomide


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