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DOI: 10.1055/s-0041-1727068
Tandem Autologous Hematopoietic Stem Cell Transplantation in Very Young Patients with Multiple Myeloma
Funding None.![](https://www.thieme-connect.de/media/10.1055-s-00049561/202004/lookinside/thumbnails/10-1055-s-0041-1727068_3_0919-1.jpg)
Abstract
Introduction Multiple myeloma (MM) in very young patients is uncommon, and no treatment guidelines exist for these patients.
Patients and Methods We performed a retrospective analysis of five very young myeloma patients who underwent tandem autologous hematopoietic stem cell transplantation (HSCT).
Results The median age was 37 years (range = 34–40 years). A median of two leukapheresis was performed (range = 1–4). The median number of hematopoietic stem cells collected was 5.4 × 106/kg (4.4–8.2 × 106/kg). During first transplant, four patients received melphalan of 200 mg/m2 and one patient received melphalan of 140 mg/m2 (due to renal failure) as conditioning regimen. Second transplant conditioning was melphalan of 200 mg/m2 for one patient and melphalan of 140 mg/m2 for remaining four patients. Two patients were in complete remission, and two were in very good partial remission and one patient progressed to active disease at the time of tandem autologous bone marrow transplant. All patients developed significant mucositis. Neutrophil and platelet recovery was longer in tandem autologous hematopoietic stem cell transplant. More viral infections were seen in tandem transplant. Day 30 and day 100 mortality was nil.
Conclusion We present data on tandem autologous HSCTs in very young patients with MM in India. Responses continued to improve in this small series.
Publication History
Article published online:
14 June 2021
© 2021. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Durie BGM, Hoering A, Abidi MH. et al. Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant (SWOG S0777): a randomised, open-label, phase 3 trial. Lancet 2017; 389 (10/068) 519-527
- 2 Kastritis E, Zervas K, Symeonidis A. et al. Improved survival of patients with multiple myeloma after the introduction of novel agents and the applicability of the International Staging System (ISS): an analysis of the Greek Myeloma Study Group (GMSG). Leukemia 2009; 23 (06) 1152-1157
- 3 Attal M, Lauwers-Cances V, Hulin C. et al; IFM 2009 Study. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. N Engl J Med 2017; 376 (14) 1311-1320
- 4 Yanamandra U, Saini N, Chauhan P. et al. AYA-myeloma: real-world, single-center experience over last 5 years. J Adolesc Young Adult Oncol 2018; 7 (01) 120-124
- 5 Dhakal B, Szabo A, Chhabra S. et al. Autologous transplantation for newly diagnosed multiple myeloma in the era of novel agent induction: a systematic review and meta-analysis. JAMA Oncol 2018; 4 (03) 343-350
- 6 Jungova A, Vokurka S, Schutzova M. et al. Comparison of autologous hematopoietic cell transplantation performed in tandem and in disease relapse in multiple myeloma patients. Neoplasma 2018; 65 (06) 952-957
- 7 Naithani R, Dayal N, Dixit G. Single versus dual platform analysis for hematopoietic stem cell enumeration using ISHAGE protocol. Indian J Hematol Blood Transfus 2017; 33 (03) 370-374
- 8 Shah N, Callander N, Ganguly S. et al; American Society for Blood and Marrow Transplantation. Hematopoietic stem cell transplantation for multiple myeloma: Guidelines from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2015; 21 (07) 1155-1166
- 9 Attal M, Harousseau JL, Facon T. et al; InterGroupe Francophone du Myélome. Single versus double autologous stem-cell transplantation for multiple myeloma. N Engl J Med 2003; 349 (26) 2495-2502
- 10 Cavo M, Tosi P, Zamagni E. et al. Prospective, randomized study of single compared with double autologous stem-cell transplantation for multiple myeloma: Bologna 96 clinical study. J Clin Oncol 2007; 25 (17) 2434-2441
- 11 Sonneveld P, van der Holt B, Segeren CM. et al; Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON). Intermediate-dose melphalan compared with myeloablative treatment in multiple myeloma: long-term follow-up of the Dutch Cooperative Group HOVON 24 trial. Haematologica 2007; 92 (07) 928-935
- 12 Sonneveld P, Schmidt-Wolf IG, van der Holt B. et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65/ GMMG-HD4 trial. J Clin Oncol 2012; 30 (24) 2946-2955
- 13 Mai EK, Benner A, Bertsch U. et al. Single versus tandem high-dose melphalan followed by autologous blood stem cell transplantation in multiple myeloma: long-term results from the phase III GMMG-HD2 trial. Br J Haematol 2016; 173 (05) 731-741
- 14 Naithani R, Dayal N, Rai R, Pathak S, Singh M. Autologous hematopoietic stem cell transplantation for multiple myeloma in India. Indian J Hematol Blood Transfus 2018; 34 (03) 564-565