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Autologous Stem Cell Transplantation for Multiple Myeloma: Single Centre Experience from North India

  • Pankaj Malhotra
  • Uday Yanamandra
  • Alka Khadwal
  • Gaurav Prakash
  • Deepesh Lad
  • Arjun D. Law
  • Harshit Khurana
  • M. U. S. Sachdeva
  • Praveen Bose
  • Reena Das
  • Neelam Varma
  • Subhash Varma
Original Article

Abstract

Autologous stem cell transplantation (ASCT) is considered as standard of care in patients with multiple myeloma (MM) patients aged 65 years or younger. We analyzed data of 94 patients of plasma cell dyscrasias who underwent 95 autologous transplants at our institute from October 2003 to Aug 2016. Other than 76 patients of newly diagnosed multiple myeloma, we also transplanted two patients of POEMS syndrome, two patients of plasma cell leukemia, three patients of concurrent light chain deposition disease, three patients of multifocal plasmacytomas, and eight patients of isolated light chain myeloma. One patient underwent transplant twice. The median age of patients was 53 years (range 21–65). The average interval between diagnosis and transplant was 10.51 ± 5.42 months. The predominant stage in the study cohort was ISS-III. IgG kappa was the commonest subtype of plasma cell dyscrasia (27.9%) followed by IgG lambda (16.27%). Renal involvement was seen in 25% patients at the time of transplantation. Following chemotherapy, 42% patients were in CR, 39% in VGPR, 5% had PR and 14% had progressive disease at the time of transplantation. All patients were conditioned with melphalan (dose 120–200 mg/m2) except for one who received an additional bortezomib for his second transplant. The mean time to neutrophil and platelet engraftment was 11.09 ± 1.82 and 12.69 ± 4.55 days respectively. Mucositis was noted in all patients (grade 3 in 37.5% patients). The median PFS (biochemical) was 55.8% and PFS (clinical) was 76.7% at 6.5 years. Thirteen percent of the transplanted patients succumbed to their illness of which three patients died within 30 days of transplant. Median OS was 76.7% at 6.5 years. ASCT is a feasible option for MM in India and the results are comparable.

keywords

ASCT  Myeloma  Real World  Transplant  Autologous 

Notes

Compliance with Ethical Standards

Conflict of interest

All Authors declare that they have no conflict of interest.

Human and Animal Rights

This research is involving human participants.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Indian Society of Haematology & Transfusion Medicine 2017

Authors and Affiliations

  • Pankaj Malhotra
    • 1
  • Uday Yanamandra
    • 2
  • Alka Khadwal
    • 1
  • Gaurav Prakash
    • 1
  • Deepesh Lad
    • 1
  • Arjun D. Law
    • 3
  • Harshit Khurana
    • 4
  • M. U. S. Sachdeva
    • 5
  • Praveen Bose
    • 5
  • Reena Das
    • 5
  • Neelam Varma
    • 5
  • Subhash Varma
    • 1
  1. 1.Clinical Haematology Division, Department of Internal MedicinePostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  2. 2.Department of Haematology and Stem Cell TransplantArmy Hospital (Research and Referral)DelhiIndia
  3. 3.Division of Medical Oncology and Haematology, Princess Margaret Cancer CentreUniversity Health Network, University of TorontoTorontoCanada
  4. 4.Department of Internal MedicineCommand Hospital (Air Force)BangaloreIndia
  5. 5.Department of HaematologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

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