Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma

Kenneth C. Anderson, Janet Andersen, Robert Soiffer, Arnold S. Freedman, Susan N. Rabinowe, Michael Robertson, Neil Spector, Kelly Blake, Christine Murray, Andrea Freeman, Felice Coral, Karen C. Marcus, Peter Mauch, Lee M. Nadler, Jerome Ritz

Research output: Contribution to journalArticle

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Abstract

Forty patients with plasma cell dyscrasias underwent high-dose chemoradiotherapy and either anti-B-cell monoclonal antibody (MoAb)-treated autologous, anti-T-cell MoAb-treated HLA-matched sibling allogeneic or syngeneic bone marrow transplantation (BMT). The majority of patients had advanced Durie-Salmon stage myeloma at diagnosis, all were pretreated with chemotherapy, and 17 had received prior radiotherapy. At the time of BMT, all patients demonstrated good performance status with Karnofsky score of 80% or greater and had less than 10% marrow tumor cells; 34 patients had residual monoclonal marrow plasma cells and 38 patients had paraprotein. Following high-dose chemoradiotherapy, there were 18 complete responses (CR), 18 partial responses, one non-responder, and three toxic deaths. Granulocytes greater than 500/μL and untransfused platelets greater than 20,000/μL were noted at a median of 23 (range, 12 to 46) and 25 (range, 10 to 175) days posttransplant (PT), respectively, in 24 of the 26 patients who underwent autografting. In the 14 patients who received allogeneic or syngeneic grafts, granulocytes greater than 500/μL and untransfused platelets greater than 20,000/μL were noted at a median of 19 (range, 12 to 24) and 16 (range, 5 to 32) days PT, respectively. With 24 months median follow-up for survival after autologous BMT, 16 of 26 patients are alive free from progression at 2+ to 55+ months PT; of these, 5 patients remain in CR at 6+ to 55+ months PT. With 24 months median follow-up for survival after allogeneic and syngeneic BMT, 8 of 14 patients are alive free from progression at 8+ to 34+ months PT; of these, 5 patients remain in CR at 8+ to 34+ months PT. This therapy has achieved high response rates and prolonged progression-free survival in some patients and proven to have acceptable toxicity. However, relapses post-BMT, coupled with slow engraftment post-BMT in heavily pretreated patients, suggest that such treatment strategies should be used earlier in the disease course. To define the role of BMT in the treatment of myeloma, its efficacy should be compared with that of conventional chemotherapy in a randomized trial.

Original languageEnglish (US)
Pages (from-to)2568-2576
Number of pages9
JournalBlood
Volume82
Issue number8
StatePublished - Oct 15 1993
Externally publishedYes

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Multiple Myeloma
Bone Marrow Transplantation
Bone
Monoclonal Antibodies
Chemoradiotherapy
Chemotherapy
Platelets
Therapeutics
Isogeneic Transplantation
Cells
Paraproteins
Plasmas
Autologous Transplantation
T-cells
Poisons
Radiotherapy
Granulocytes
Grafts
Toxicity
Tumors

ASJC Scopus subject areas

  • Hematology

Cite this

Anderson, K. C., Andersen, J., Soiffer, R., Freedman, A. S., Rabinowe, S. N., Robertson, M., ... Ritz, J. (1993). Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma. Blood, 82(8), 2568-2576.

Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma. / Anderson, Kenneth C.; Andersen, Janet; Soiffer, Robert; Freedman, Arnold S.; Rabinowe, Susan N.; Robertson, Michael; Spector, Neil; Blake, Kelly; Murray, Christine; Freeman, Andrea; Coral, Felice; Marcus, Karen C.; Mauch, Peter; Nadler, Lee M.; Ritz, Jerome.

In: Blood, Vol. 82, No. 8, 15.10.1993, p. 2568-2576.

Research output: Contribution to journalArticle

Anderson, KC, Andersen, J, Soiffer, R, Freedman, AS, Rabinowe, SN, Robertson, M, Spector, N, Blake, K, Murray, C, Freeman, A, Coral, F, Marcus, KC, Mauch, P, Nadler, LM & Ritz, J 1993, 'Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma', Blood, vol. 82, no. 8, pp. 2568-2576.
Anderson KC, Andersen J, Soiffer R, Freedman AS, Rabinowe SN, Robertson M et al. Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma. Blood. 1993 Oct 15;82(8):2568-2576.
Anderson, Kenneth C. ; Andersen, Janet ; Soiffer, Robert ; Freedman, Arnold S. ; Rabinowe, Susan N. ; Robertson, Michael ; Spector, Neil ; Blake, Kelly ; Murray, Christine ; Freeman, Andrea ; Coral, Felice ; Marcus, Karen C. ; Mauch, Peter ; Nadler, Lee M. ; Ritz, Jerome. / Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma. In: Blood. 1993 ; Vol. 82, No. 8. pp. 2568-2576.
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