Československý transplantační kongres
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1. československý transplantační kongres 2. československý transplantační kongres |
Konferenční abstrakta 2008
Abstrakta přednášek – sekce lékařů
TRANSPLANTATION FOR PATIENTS WITH MULTIPLE MYELOMA. A SINGLE CENTER EXPERIENCES
E. Tóthová, N. Štecová, A. Kafková, T. Guman, M. Fričová, I. Duľová
Department of Hematology and Oncohematology, University Hospital L. Pasteura and University P.J. Šafarik, Košice, Slovak Republic
• Klinika hematológie a onkohematológie, FN l. Pasteura, Rastislavova 43, 041 90 Košice
Background: High-dose chemotherapy with autologous stem cell transplantation (ASCT) is currently the standard treatment in myeloma patients under 65 years. Aim: The aim of this study is to evaluate the feasibility and efficacy of ASCT in multiple myeloma (MM) patients and compare results between single and multiple transplants.
Methods: From October 1998 to October 2007 we performed 76 ASCT in 58 multiple myeloma patients (median 59 years; range 31-65; male 36; female 22). Thirty seven patients were transplanted with a single course (31 patients and 6 patients due to inelegibility for second transplant: toxic side effects: cardiotoxicity (2); neurotoxicity (1); late infections (3) ). Twenty one patients underwent multiple course of transplantation (20 double and 1 tripple ASCT). Conditioning chemotherapy consisted of melphalan 200mg/ m2 for single and double ASCT. All patients received peripheral stem cells.
Results: No significant differences between both groups were seen according to age, sex or stage of disease at the time of ASCT, but more patients who relapsed after conventional treatment were included in the single than in the multiple ASCT group (15 vs 5 patients). Transplant related mortality was 0% and serious adverse events are similar in the both groups (19% vs 21%). The hematological recovery (median time for PMN more than 0,5/g/L (11, range5-14) days and to PLTmore than 50g/L (13, range 7-56 days) did not differ between the first or the following transplants. All patients responded to ASCT. In the single ASCT group 1 and in the double ASCT group 1 patients had progressive disease shortly after second ASCT. The complete remission rates (CCR) were different between single and multiple transplant groups (34% vs 46%). No significant difference could be seen in median progression free survival (25 vs 28 months) and the median overall survival (69 months vs note related yet), caused by a longer observation time for single ASCT.
Conclusion: High-dose melphalan followed by ASCT in the younge patients have been considered the standard of care for initial therapy of myeloma patients. Survival after transplant appears to be related to the achievement of CR or VGPR. Because the number of complete remission rate was increased after second transplant, we recommend second transplant to all patients who did not achieve CR after singlue and did not get contraindication to ASCT.