Vnitr Lek 1998, 44(12):698-701
[Autologous transplantation of peripheral stem cells in treatment of recurrent multiple myeloma].
- II. interní hematoonkologická klinika FN, Brno-Bohunice.
Treatment of relapses of multiple myeloma is a problem which was not resolved quite satisfactorily so far. One of the possible therapeutic approaches is administration of major doses of chemotherapeutic agents with the support of autologous transplantation. As compared with standard treatment, according to some authors thus more remissions are achieved and a longer overall survival. The submitted paper provides information on the therapeutic results in relapses of multiple myeloma by administration of large doses of melfalan (200 mg/m2) with support of autologous transplantation in seven patients in the authors department. In these patients for stimulation smaller doses of cyclophosphamide were used (2-3 g/m2) and in half of them also larger doses of leucocytic growth factor (16 micrograms/kg) than usually in newly treated patients with multiple myeloma who receive as part of the stimulating regime 5 g/m2 cyclophosphamide and 10 micrograms/kg leucocytic growth factor. The yield of peripheral stem cells was good in all these patients. Of five patients with a chemosensitive relapse of the disease the authors achieved after transplantation three remissions and two partial remissions. So far all patients survive, one in relapse, two in remission, two in partial remission. Of the two patients with a chemoresistant relapse one died on the 17th day after transplantation, the other one achieved temporary 6-month remission and then died during the second fulminant relapse of the disease. Autologous transplantation seems to be an asset in particular in patients with a chemosensitive relapse of the disease. The authors summarize hitherto known facts concerning this problem published in the literature abroad.
Keywords: Adult; Antineoplastic Combined Chemotherapy Protocols, therapeutic use, ; Combined Modality Therapy; Female; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Multiple Myeloma, therapy, ; Recurrence; Transplantation, Autologous
Published: December 1, 1998 Show citation