Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Myeloma-Lymphoma

A simplified method for stem cell autografting in multiple myeloma: a single institution experience

Abstract

In a 14-year period in a single institution 31 autografts were performed in 26 patients with multiple myeloma (MM), using a simplified and affordable autografting procedure: conducting the grafts on an outpatient basis and avoiding stem cell freezing. Autografts were started on an outpatient basis in all instances, but four patients were admitted to the hospital. Median time to achieve more than 0.5 × 109/l granulocytes was 27 days, whereas median time to recover above 20 × 109/l plts was 37 days. CR was achieved in 19 cases and a very good partial response in 6 cases. The 100-day mortality was 9.6%. The overall median post-transplant survival has not been reached, being above 76 months, whereas the 76-month survival is 80%. The median cost of each procedure was US$ 15 000. Survival results were substantially better than those of historical control in a group of patients treated in the same institution with melphalan/prednisone. It is concluded that high-dose therapy rescued with a simplified autologous stem cell graft is a valid, useful and affordable therapeutic option for patients with MM, even with economical restraints.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

References

  1. Caers Jo, Vandebroek I, De Raeve H, Michaux L, Trullemans F, Schots R et al. Multiple myeloma. An update on diagnosis and treatment. Eur J Haematol 2008; 81: 329–343.

    CAS  PubMed  Google Scholar 

  2. Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 2003; 78: 21–33.

    Article  PubMed  Google Scholar 

  3. Ruiz-Delgado GJ, Ruiz-Argüelles GJ . Genetic predisposition for monoclonal gammopathy of undetermined significance. Mayo Clin Proc 2008; 83: 601–603.

    Article  PubMed  Google Scholar 

  4. Ruiz-Argüelles GJ, Gómez-Rangel D, Ruiz-Delgado GJ, Aguilar-Romero L . Multiple myeloma in México: a single institution, twenty-year experience. Arch Med Res 2004; 35: 163–167.

    Article  PubMed  Google Scholar 

  5. Alexanian R, Dimopoulos M . The treatment of multiple myeloma. N Engl J Med 1994; 330: 484–489.

    Article  CAS  PubMed  Google Scholar 

  6. Vela-Ojeda J, García-Ruiz-Esparza MA, Padilla-González Y, Gómez-Almaguer D, Gutiérrez-Aguirre CH, Gómez-Rangel D et al. Autologous peripheral blood stem cell transplantation in multiple myeloma using oral versus IV melphalan. Ann Hematol 2007; 86: 277–282.

    Article  CAS  PubMed  Google Scholar 

  7. Kessinger A, Armitage JO, Landmark JD, Smith DM, Weisenburger DD . Autologous peripheral hematopoietic stem cell transplantation restores hemopoietic function following marrow ablative therapy. Blood 1988; 71: 723–727.

    CAS  PubMed  Google Scholar 

  8. Ruiz-Argüelles A . Flow cytometry in the clinical laboratory. Principles, applications and problems. Ann Biol Clin 1992; 50: 735–743.

    Google Scholar 

  9. Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Bladé J et al. International staging system for multiple myeloma. J Clin Oncol 2005; 23: 3412–3420.

    Article  PubMed  Google Scholar 

  10. Ruiz-Argüelles GJ, Gómez-Rangel D, Ruiz-Delgado GJ, Ruiz-Argüelles A, Pérez-Romano B, Rivadeneyra L . Results of an autologous non-cryopreserved, unmanipulated peripheral blood hematopoietic stem cell transplant program: a single institution, 10-year experience. Acta Haematol 2003; 110: 179–183.

    Article  PubMed  Google Scholar 

  11. Ruiz-Argüelles GJ . Amoebic paralytic ileus in a patient given an autologous stem cell transplantation. Haema 2006; 9: 431–432.

    Google Scholar 

  12. Mehta J, Singhal S . Current status of autologous hematopoietic stem cell transplantation in myeloma. Bone Marrow Transplant 2008; 42 (Suppl 1): S28–S34.

    Article  PubMed  Google Scholar 

  13. López-Otero A, Ruiz-Delgado GJ, Ruiz-Argüelles GJ . Es cierto que el trasplante de médula ósea autóloga mejora el pronóstico de los pacientes con mieloma múltiple?: Experiencia de una sola institución en México. Medicina Universitaria 2008; 10: 187–189.

    Google Scholar 

  14. Gertz MA, Ansell SM, Dingli D, Dispenzieri A, Buadi FK, Elliott MA et al. Autologous stem cell transplant in 716 patients with multiple myeloma: low treatment-related mortality, feasibility of outpatient transplant, and effect of a multidisciplinary quality initiative. Mayo Clin Proc 2008; 83: 1131–1138.

    Article  PubMed  Google Scholar 

  15. Ruiz-Argüelles GJ, Ruiz-Argüelles A, Pérez-Romano B, Marín-López A, Delgado-Lamas JL . Non-cryopreserved peripheral blood stem cells autotransplants for hematological malignancies can be performed entirely on an outpatient basis. Am J Hematol 1998; 58: 161–164.

    Article  PubMed  Google Scholar 

  16. Ruiz-Argüelles GJ . Outpatient programs of myeloablative chemotherapy, autologous and allogeneic bone marrow transplantation. Haematologica 2000; 85: 1233–1234.

    PubMed  Google Scholar 

  17. Gómez-Almaguer D . The simplification of the SCT procedures in developing countries has resulted in cost-lowering and availability to more patients. Int J Hematol 2002; 76 (Suppl 1): 380–382.

    Article  PubMed  Google Scholar 

  18. Ruiz-Argüelles GJ, Ruiz-Argüelles A, Pérez-Romano B, Marín-López A, Larregina-Díez A, Apreza-Molina MG . Filgrastim-mobilized peripheral-blood stem cells can be stored at 4 degrees and used in autografts to rescue high-dose chemotherapy. Am J Hematol 1995; 48: 100–103.

    Article  PubMed  Google Scholar 

  19. Thomas ED . Hematopoietic stem cell transplantation. Sci Am 1995; 272: 38–47.

    Google Scholar 

  20. Gajewski JL, Robinson P . Do affluent societies have the only option for the best therapy? Leukemia 2007; 21: 387–388.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to G J Ruiz-Argüelles.

Rights and permissions

Reprints and permissions

About this article

Cite this article

López-Otero, A., Ruiz-Delgado, G. & Ruiz-Argüelles, G. A simplified method for stem cell autografting in multiple myeloma: a single institution experience. Bone Marrow Transplant 44, 715–719 (2009). https://doi.org/10.1038/bmt.2009.71

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2009.71

Keywords

This article is cited by

Search

Quick links