Wichard Vogel1, Hans-Georg Kopp, Lothar Kanz, Hermann Einsele. 1. Department of Internal Medicine II, Division of Hematology, Oncology, Immunology and Rheumatology, University of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany.
Abstract
PURPOSE: High-dose chemotherapy with hematopoietic stem-cell rescue is increasingly being used in the treatment of multiple myeloma. Bone marrow and also peripheral blood stem-cell (PBSC) grafts contain measurable quantities of plasma cells, the biological significance of which is unknown. METHODS: Patients with multiple myeloma were mobilized with chemotherapy and filgrastim. The number of CD38++/CD138+ cells/kg in the grafts for autologous transplantation was determined by flow cytometry. Patients were stratified into two groups (threshold 4.5 x 10(5) plasma cells kg(-1)) of reinfused plasma cells in the first autologous graft. RESULTS: The median statistical progression-free survival was 14 months (4-34 months) in the high-contamination group (>4.5 x 10(5) plasma cells kg(-1)) compared to 26 months (4-43 months) in the low-contamination group (<4.5 x 10(5) plasma cells kg(-1), P =0.0096). Patients with 13q deletion were more frequently found to have a high contamination of the stem-cell graft with malignant plasma cells. CONCLUSIONS: Patients with graft contamination of more than 4.5 x 10(5) plasma cells kg(-1) had a high risk of early disease progression after high-dose chemotherapy. In vivo tumor cell purging prior to mobilization chemotherapy might be one strategy to improve the time to progression of high-risk patients.
PURPOSE: High-dose chemotherapy with hematopoietic stem-cell rescue is increasingly being used in the treatment of multiple myeloma. Bone marrow and also peripheral blood stem-cell (PBSC) grafts contain measurable quantities of plasma cells, the biological significance of which is unknown. METHODS:Patients with multiple myeloma were mobilized with chemotherapy and filgrastim. The number of CD38++/CD138+ cells/kg in the grafts for autologous transplantation was determined by flow cytometry. Patients were stratified into two groups (threshold 4.5 x 10(5) plasma cells kg(-1)) of reinfused plasma cells in the first autologous graft. RESULTS: The median statistical progression-free survival was 14 months (4-34 months) in the high-contamination group (>4.5 x 10(5) plasma cells kg(-1)) compared to 26 months (4-43 months) in the low-contamination group (<4.5 x 10(5) plasma cells kg(-1), P =0.0096). Patients with 13q deletion were more frequently found to have a high contamination of the stem-cell graft with malignant plasma cells. CONCLUSIONS:Patients with graft contamination of more than 4.5 x 10(5) plasma cells kg(-1) had a high risk of early disease progression after high-dose chemotherapy. In vivo tumor cell purging prior to mobilization chemotherapy might be one strategy to improve the time to progression of high-risk patients.
Authors: Jesús F San Miguel; Julia Almeida; Gema Mateo; Joan Bladé; Consuelo López-Berges; Dolores Caballero; José Hernández; María Jesús Moro; Javier Fernández-Calvo; Joaquín Díaz-Mediavilla; Luis Palomera; Alberto Orfao Journal: Blood Date: 2002-03-01 Impact factor: 22.113
Authors: M Boccadoro; P Omedé; A Dominietto; A Palumbo; S Bringhen; F Giaretta; B Ortolano; S Triolo; A Pileri Journal: Bone Marrow Transplant Date: 2000-01 Impact factor: 5.483
Authors: H Einsele; M Bamberg; W Budach; H Schmidberger; C F Hess; B Wörmann; C Meisner; C Straka; H Hebart; L Trümper; N Kröger; A R Zander; S Hegewisch-Becker; D K Hossfeld; H Schmidt; P Müller; G Schlimok; B Hertenstein; D Peest; B Metzner; N Frickhofen; L Kanz; W I Bensinger Journal: Bone Marrow Transplant Date: 2003-09 Impact factor: 5.483
Authors: R M Lemoli; G Martinelli; E Zamagni; M R Motta; S Rizzi; C Terragna; R Rondelli; S Ronconi; A Curti; F Bonifazi; S Tura; M Cavo Journal: Blood Date: 2000-04-01 Impact factor: 22.113
Authors: P Omedè; C Tarella; A Palumbo; C Argentino; D Caracciolo; P Corradini; A Dominietto; F Giaretta; R Ravaglia; R Triolo; S Triolo; A Pileri; M Boccadoro Journal: Br J Haematol Date: 1997-12 Impact factor: 6.998
Authors: A K Stewart; R Vescio; G Schiller; O Ballester; S Noga; H Rugo; C Freytes; E Stadtmauer; S Tarantolo; F Sahebi; P Stiff; J Meharchard; R Schlossman; R Brown; H Tully; M Benyunes; C Jacobs; R Berenson; M White; J DiPersio; K C Anderson; J Berenson Journal: J Clin Oncol Date: 2001-09-01 Impact factor: 44.544
Authors: Animesh Pardanani; Thomas E Witzig; Georgene Schroeder; Edwin A McElroy; Rafael Fonseca; Angela Dispenzieri; Martha Q Lacy; John A Lust; Robert A Kyle; Philip R Greipp; Morie A Gertz; S Vincent Rajkumar Journal: Blood Date: 2002-09-05 Impact factor: 22.113
Authors: M Mohty; K Hübel; N Kröger; M Aljurf; J Apperley; G W Basak; A Bazarbachi; K Douglas; I Gabriel; L Garderet; C Geraldes; O Jaksic; M W Kattan; Z Koristek; F Lanza; R M Lemoli; L Mendeleeva; G Mikala; N Mikhailova; A Nagler; H C Schouten; D Selleslag; S Suciu; A Sureda; N Worel; P Wuchter; C Chabannon; R F Duarte Journal: Bone Marrow Transplant Date: 2014-03-31 Impact factor: 5.483
Authors: Asad Bashey; Waleska S Pérez; Mei-Jie Zhang; Kenneth C Anderson; Karen Ballen; James R Berenson; L Bik To; Rafael Fonseca; César O Freytes; Robert Peter Gale; John Gibson; Sergio A Giralt; Robert A Kyle; Hillard M Lazarus; Dipnarine Maharaj; Philip L McCarthy; Gustavo A Milone; Stephen Nimer; Santiago Pavlovsky; Donna E Reece; Gary Schiller; David H Vesole; Parameswaran Hari Journal: Biol Blood Marrow Transplant Date: 2008-10 Impact factor: 5.742
Authors: Eric Bartee; Winnie M Chan; Jan S Moreb; Christopher R Cogle; Grant McFadden Journal: Biol Blood Marrow Transplant Date: 2012-04-16 Impact factor: 5.742
Authors: Tracy R Daniels-Wells; Gustavo Helguera; José A Rodríguez; Lai Sum Leoh; Michael A Erb; Graciel Diamante; David Casero; Matteo Pellegrini; Otoniel Martínez-Maza; Manuel L Penichet Journal: Toxicol In Vitro Date: 2012-10-17 Impact factor: 3.500