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Long-term follow-up of T cell-depleted allogeneic bone marrow transplantation in refractory multiple myeloma: importance of allogeneic T cells.

Publication ,  Journal Article
Huff, CA; Fuchs, EJ; Noga, SJ; O'Donnell, PV; Ambinder, RF; Diehl, L; Borrello, I; Vogelsang, GB; Miller, CB; Flinn, IA; Brodsky, RA ...
Published in: Biol Blood Marrow Transplant
May 2003

Multiple myeloma may be cured by myeloablative conditioning and allogeneic blood or marrow transplantation (alloBMT), but this occurs at the expense of high transplant-related mortality. In an endeavor to reduce procedure-related toxicity, this study retrospectively evaluated the safety, tolerability, and efficacy of T cell depletion by counterflow centrifugal elutriation before alloBMT. Fifty-one patients with stage II (6) or III (45) multiple myeloma received alloBMTs using T cell depletion by elutriation. Fifty-three percent (27 of 51) of patients had primary refractory disease at the time of transplantation, 10% (5 of 51) had relapsed disease, and 4% (2 of 51) had refractory relapsed disease. The median age was 49 (range, 32 to 62) years, and the median time from diagnosis to transplantation was 9 (range, 4 to 58) months. Patients had received a median of 1 (range, 1 to 3) regimen and 4 (range, 2 to 16) cycles of chemotherapy. In this population, transplant-related mortality rate was 24% (12 of 51) with 2 patients dying of graft-versus-host disease (GVHD). Thirty-one of 39 evaluable patients have experienced relapse, and the probability of progression-free survival 5 years after alloBMT alone is 16%. Sixteen patients were given donor lymphocyte infusions (DLI) at the time of relapse (n = 11) or for persistent disease 1 year after transplantation (n = 5). Acute or chronic GVHD was seen in 63% (10 of 16) of patients given DLI. Responses were seen in 8 of 16 patients (6 complete response [CR], 2 partial response [PR]) with 6 of 8 responding patients having GVHD. Five recipients of DLI remain in a continuous CR, ranging from 3 to 64 months in duration. Thus, like chronic myelogenous leukemia, allogeneic T cells appear to have potent antimyeloma activity that is critical for achieving a cure. DLI-induced remissions of multiple myeloma can be durable, even in patients with refractory multiple myeloma. Unlike chronic myelogenous leukemia, the antimyeloma effect of allogeneic T cells rarely occurs in the absence of clinically significant GVHD.

Duke Scholars

Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

May 2003

Volume

9

Issue

5

Start / End Page

312 / 319

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Survival Analysis
  • Prognosis
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Lymphocyte Transfusion
  • Lymphocyte Depletion
  • Immunology
 

Citation

APA
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ICMJE
MLA
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Huff, C. A., Fuchs, E. J., Noga, S. J., O’Donnell, P. V., Ambinder, R. F., Diehl, L., … Jones, R. J. (2003). Long-term follow-up of T cell-depleted allogeneic bone marrow transplantation in refractory multiple myeloma: importance of allogeneic T cells. Biol Blood Marrow Transplant, 9(5), 312–319. https://doi.org/10.1016/s1083-8791(03)00075-2
Huff, Carol Ann, Ephraim J. Fuchs, Stephen J. Noga, Paul V. O’Donnell, Richard F. Ambinder, Louis Diehl, Ivan Borrello, et al. “Long-term follow-up of T cell-depleted allogeneic bone marrow transplantation in refractory multiple myeloma: importance of allogeneic T cells.Biol Blood Marrow Transplant 9, no. 5 (May 2003): 312–19. https://doi.org/10.1016/s1083-8791(03)00075-2.
Huff CA, Fuchs EJ, Noga SJ, O’Donnell PV, Ambinder RF, Diehl L, et al. Long-term follow-up of T cell-depleted allogeneic bone marrow transplantation in refractory multiple myeloma: importance of allogeneic T cells. Biol Blood Marrow Transplant. 2003 May;9(5):312–9.
Huff, Carol Ann, et al. “Long-term follow-up of T cell-depleted allogeneic bone marrow transplantation in refractory multiple myeloma: importance of allogeneic T cells.Biol Blood Marrow Transplant, vol. 9, no. 5, May 2003, pp. 312–19. Pubmed, doi:10.1016/s1083-8791(03)00075-2.
Huff CA, Fuchs EJ, Noga SJ, O’Donnell PV, Ambinder RF, Diehl L, Borrello I, Vogelsang GB, Miller CB, Flinn IA, Brodsky RA, Marcellus D, Jones RJ. Long-term follow-up of T cell-depleted allogeneic bone marrow transplantation in refractory multiple myeloma: importance of allogeneic T cells. Biol Blood Marrow Transplant. 2003 May;9(5):312–319.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

May 2003

Volume

9

Issue

5

Start / End Page

312 / 319

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Survival Analysis
  • Prognosis
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Lymphocyte Transfusion
  • Lymphocyte Depletion
  • Immunology