Bone Grafts Research Today is a free monthly online journal that collates and summarizes the latest research about Bone Grafts, including details on spine fusion, surgery, procedure, risks.

Myeloma cell contamination of peripheral blood stem-cell grafts can predict the outcome in multiple myeloma patients after high-dose chemotherapy and autologous stem-cell transplantation.

Vogel W, Kopp HG, Kanz L, Einsele H

Department of Internal Medicine II, Division of Hematology, Oncology, Immunology and Rheumatology, University of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany.

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.

Published 8 February 2005 in J Cancer Res Clin Oncol, 131(4): 214-8.
Full-text of this article is available online (may require subscription).

© 2004-2008 Bone Grafts Research Today. All Rights Reserved.