Comparison of marrow vs blood-derived stem cells for autografting in previously untreated multiple myeloma
Open Access
- 1 June 1997
- journal article
- research article
- Published by Springer Nature in British Journal of Cancer
- Vol. 75 (11) , 1684-1689
- https://doi.org/10.1038/bjc.1997.286
Abstract
Sixty-three new untreated patients with multiple myeloma under the age of 70 years received C-VAMP induction treatment followed by high-dose intravenous melphalan (200 mg m(-2)) and autologous stem cell transplant, either with marrow [autologous bone marrow transplants (ABMT), n = 26] or with granulocyte colony-stimulating factor (G-CSF)-mobilized stem cells from the blood [peripheral blood stem cell transplants (PBSCT), n = 37]. This was a sequential study and the two groups were not significantly different for all known prognostic variables. The complete remission (CR) rate after high-dose treatment was the same for both groups [ABMT 84% and PBSCT 70%; P = not significant (NS)]. Neutrophil recovery to 0.5 x 10(9) l(-1) occurred at a median of 22 days in the ABMT patients compared with 19 days for the PBSCT patients (P = NS). Platelet recovery to 50 x 10(9) l(-1) was significantly faster in PBSCT patients (19 days vs 33 days; P = 0.0015), and the PBSCT patients spent fewer days in hospital (median 20 vs 27 days; P = 0.00001). There was no difference in the two groups with respect to starting interferon (58 days for ABMT vs 55 days for PBSCT), and tolerance to interferon was identical. The median overall survival (OS) and progression-free survival (PFS) for the PBSCT patients has not yet been reached. The OS in the ABMT patients at 3 years was 76.9% (95% CI 60-93%) compared with 85.3% (95% CI 72-99%) in the PBSCT patients (P = NS), and the PFS at 3 years in the ABMT patients was 53.8% (95% CI 34-73%) and in the PBSCT patients was 57.6% (95% CI 34-81%) (P = NS). The probability of relapse at 3 years was 42.3% in the ABMT arm compared with 40% in the PBSCT patients (P = NS). Thus, PBSCT patients had a faster engraftment and a shorter stay in hospital than ABMT; the survival outcome and probability of relapse was the same for both groups.Keywords
This publication has 19 references indexed in Scilit:
- Comparison of Interferon Tolerance after Autologous Bone Marrow or Peripheral Blood Stem Cell Transplants for Myeloma Patients who have Responded to Induction TherapyLeukemia & Lymphoma, 1996
- Rapid progression of multiple myeloma following G-CSF mobilization.1994
- Peripheral blood stem cells (PBSCs) collected after recombinant granulocyte colony stimulating factor (rhG‐CSF): an analysis of factors correlating with the tempo of engraftment after transplantationBritish Journal of Haematology, 1994
- Myeloma cell contamination of peripheral blood stem cell grafts in patients with multiple myeloma treated by high-dose therapy.1994
- High-dose melphalan and autologous bone marrow transplantation as consolidation in previously untreated myeloma.Journal of Clinical Oncology, 1994
- Thiotepa, busulfan, and cyclophosphamide: a new preparative regimen for autologous marrow or blood stem cell transplantation in high-risk multiple myeloma.1993
- High-dose chemoradiotherapy and autologous blood stem cell transplantation in multiple myeloma: results of a phase II trial involving 63 patients.1993
- INTENSIVE TREATMENT OF MULTIPLE MYELOMA AND CRITERIA FOR COMPLETE REMISSIONThe Lancet, 1989
- Multiple myeloma treated with high dose intravenous melphalanBritish Journal of Haematology, 1987
- HIGH-DOSE INTRAVENOUS MELPHALAN FOR PLASMA-CELL LEUKAEMIA AND MYELOMAThe Lancet, 1983