Methods for estimation of bone marrow plasma cell involvement in myeloma: Predictive value for response and survival in patients undergoing autologous stem cell transplantation

2001 ◽  
Vol 68 (4) ◽  
pp. 269-275 ◽  
Author(s):  
S. Vincent Rajkumar ◽  
Rafael Fonseca ◽  
Angela Dispenzieri ◽  
Martha Q. Lacy ◽  
John A. Lust ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Plasma Cell ◽  
Predictive Value ◽  
Bone Marrow Plasma

scholarly journals Bone marrow plasma cell ratio, is it must to evaluate before autologous stem cell transplantation in multiple myeloma?

2020 ◽  
Vol 7 (4) ◽  
pp. 470-474
Author(s):  
Semih Başcı ◽  
Tuğçe Nur Yiğenoğlu ◽  
Mehmet Bakırtaş ◽  
Bahar Uncu Ulu ◽  
Derya Şahin ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Plasma Cell ◽  
Cell Ratio ◽  
Monoclonal Protein ◽  
Bone Marrow Plasma ◽  
Serum And Urine

Objective:  Complete remission in multiple myeloma (MM) is a defined as having a <5% bone marrow plasma cell (BMPC) ratio plus negative serum and urine immunofixation tests. However, it is necessary to reassess whether or not the bone marrow plasma cell ratio should be determined before transplantation in secretory multiple myeloma patients. A significant decrease in monoclonal protein levels or having negative serum and urine immunofixation tests after induction therapy might be enough to indicate chemo-sensitivity. Material and Methods: In this study, the data of 177 multiple myeloma patients that underwent autologous stem cell transplantation (ASCT) in our center were retrospectively evaluated. Results: We found a statistically significant difference in the post-ASCT response rates between the patients with a pre-ASCT BMPC ratio <5% vs BMPC ratio ≥5% (p:<0.001*). The 2-year progression-free survival (PFS) of the patients with BMPC ratio <5% and ≥5% post-ASCT was found 24% and 25% (median PFS 11 months (95% CI; 6,68-15,31) vs 12 months (95% CI; 9,47-14,53)) respectively (p: 0.900). The 2-year overall survival (OS), was 67% and 63% (median OS 35 months (95% CI; 25,59-44,41) vs 40 months (95% CI; 27,52-52,47)) respectively (p: 0.341). Conclusion: Patients with decreasing monoclonal protein in serological tests, the pre-ASCT BMPC ratio was not found to have an impact on neutrophil and platelet engraftment durations, transplantation related mortality (TRM), PFS and OS. Our study suggests that in MM patients with measurable disease, it is not required to evaluate the BMPC ratio if serologic response exists.

scholarly journals Beginning of a Journey of Autologous Stem Cell Transplantation in Combined Military Hospital, Dhaka, Bangladesh

2018 ◽  
Vol 8 (2) ◽  
pp. 177-180
Author(s):  
Mohammed Mosleh Uddin ◽  
Huque Mahfuz ◽  
Md Mostafil Karim
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Hodgkin Lymphoma ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Peripheral Blood ◽  
Haematopoietic Stem Cell ◽  
Military Hospital

Haematopoietic stem cell transplantation (HSCT) involves the intravenous infusion of autologous or allogenic stem cells collected from bone marrow, peripheral blood or umbilical cord to re-establish haematopoietic function in patients whose bone marrow or immune system is damaged or defective. HSCT are mainly of two types –autologous stem cell transplantation (SCT) and allogenic SCT. Autologous SCT is mainly performed in multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma and less commonly in acute myeloid leukaemia. Haematopoietic stem cells are mobilized from bone marrow to the peripheral blood after the use of mobilizing agents, granulocyte colony stimulating factor (G-CSF) and plerixafor. Then the mobilized stem cells are collected from peripheral blood by apheresis and cryo-preserved. The patient is prepared by giving conditioning regimen (high dose melphelan). Stem cells, which are already collected, are re-infused into patient’s circulation by a blood transfusion set. Engraftment happens 7-14 days after auto SCT. Common side effects of this procedure include nausea, vomiting, diarrhoea, mucositis, infections etc. The first case of SCT performed in Combined Military Hospital, Dhaka, Bangladesh is presented here.Birdem Med J 2018; 8(2): 177-180

Aggressive Primary Chemotherapy Plus Autologous Stem Cell Transplantation Improves Outcome for Peripheral T Cell Lymphomas Compared with CHOP-Like Regimens.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1660-1660 ◽  
Author(s):  
Michal Sieniawski ◽  
James Lennard ◽  
Christopher Millar ◽  
Simon Lyons ◽  
Philip Mounter ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
T Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Peripheral T Cell Lymphoma ◽  
Alk Positive

Abstract Abstract 1660 Poster Board I-686 Background In the past two decades we have observed improvement in the outcome of patients diagnosed with some subtypes of lymphoma. However, the prognosis of patient with peripheral T-cell lymphoma (PTCL) still remains unsatisfactory. We prospectively evaluated aggressive chemotherapy and autologous stem cell transplantation (ASCT): IVE/MTX-ASCT in patients with de-novo PTCL. Patients and methods: The regimen was piloted from 1997 for new patients eligible for intensive treatment: first for pts with enteropathy associated T-cell lymphoma (EATL) and subsequently for other types of PTCL. This therapy delivers one cycle of CHOP, followed by 3 courses of IVE (ifosfamide, etoposide, epirubicin), alternating with intermediate dose methotrexate (MTX). Stem cells are harvested after IVE and complete remissions (CR) were consolidated with myeloablative ASCT. The patients were evaluated with an intent to treat analysis for feasibility, response, progression free survival (PFS) and overall survival (OS). Results 57 patients were treated with the aggessive regimen, 26 pts had EATL and 31 other types of PTCL: 17 peripheral T-cell lymphoma NOS, 6 anaplastic T-cell lymphoma ALK positive, 4 extranodal NK/T cell lymphoma nasal type, 3 anaplastic T-cell lymphoma ALK negative and 1 hepatosplenic gamma/delta T-cell lymphoma. The median age at diagnosis was 51 years (range 23 – 69), 36/57 (63%) pts were male and 27/55 (49%) presented with ECOG >1. Early stage disease was diagnosed in 22/57 (39%) pts and advanced disease in 35/57 (61%). Bone marrow was involved in 6/53 (11%) pts and LDH was elevated in 23/46 (50%). Among pts with primary nodal disease 14/26 (54%) had at least one extranodal site involved and 6/26 (23%) bulky disease. At present, 55 pts are available for response evaluation. Eight pts discontinued treatment prematurely; 4 due to toxicity (one severe sepsis and death, one severe encephalopathy, one bone marrow failure and one bleeding from the gastrointestinal tract), and four pts due to disease progression. Of the remaining 47 pts 33 went on to receive ASCT. ASCT was omitted due to: refractory disease in 5 pts, poor general condition in 4 pts, insufficient stem cell mobilisation in 4 pts and one pt declined further treatment. The most common severe toxicities were pancytopenia, infection, nausea/vomiting and obstruction/perforation. Complete remission was confirmed in 39/55 (71%) pts, partial remission in 3/55 (5%) pts and 13/55 (24%) pts failed the treatment. The remission rates were: CR-17/26 (65%) pts and PR-1/26 (4%) for EATL and 22/29 (76%) and 2/29 (7%), respectively for other PTCL. During the study time 17/57 (30%) pts died, 15 due to lymphoma. For all pts 3-years PFS was 59% and OS 67%. For pts with EATL the 3-years PFS and OS were 52% and 60% and for other types 65% and 72%, respectively. These results were unchanged after the exclusion of anaplastic T-cell lymphoma ALK positive: (61% and 72%, respectively). Conclusions For patients with PTCL, we propose that intensive chemotherapy and ASCT significantly improves outcome compared to CHOP-like regimens, and has acceptable toxicities. In conclusion, where feasible patients with PTCL should be considered for aggressive treatments, like IVE/MTX – ASCT as primary therapy. Disclosures No relevant conflicts of interest to declare.

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