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

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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.

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Authors and Affiliations

  1. Clinical Haematology Division, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    Pankaj Malhotra, Alka Khadwal, Gaurav Prakash, Deepesh Lad & Subhash Varma

  2. Department of Haematology and Stem Cell Transplant, Army Hospital (Research and Referral), Delhi, 110010, India

    Uday Yanamandra

  3. Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada

    Arjun D. Law

  4. Department of Internal Medicine, Command Hospital (Air Force), Bangalore, India

    Harshit Khurana

  5. Department of Haematology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    M. U. S. Sachdeva, Praveen Bose, Reena Das & Neelam Varma

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  1. Pankaj Malhotra
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  2. Uday Yanamandra
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Correspondence to Pankaj Malhotra.

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This research is involving human participants.

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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.

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

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Malhotra, P., Yanamandra, U., Khadwal, A. et al. Autologous Stem Cell Transplantation for Multiple Myeloma: Single Centre Experience from North India. Indian J Hematol Blood Transfus 34, 261–267 (2018). https://doi.org/10.1007/s12288-017-0876-y

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  • DOI: https://doi.org/10.1007/s12288-017-0876-y

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