Unrelated Cord Blood Transplantation with a Reduced-Intensity Conditioning Regimen following Autologous Transplantation for Multiple Myeloma

  • Toshiki Yamada
  • Akira Tomonari
  • Satoshi Takahashi
  • Jun Ooi
  • Tohru Iseki
  • Yoko Shimohakamada
  • Kashiya Takasugi
  • Nobuhiro Ohno
  • Fumitaka Nagamura
  • Kaoru Uchimaru
  • Arinobu Tojo
  • Hisataka Moriwaki
  • Shigetaka Asano
Case Report

DOI: 10.1532/IJH97.04091

Cite this article as:
Yamada, T., Tomonari, A., Takahashi, S. et al. Int J Hematol (2004) 80: 377. doi:10.1532/IJH97.04091

Abstract

Two patients, 51- and 45-year-old men with stage III immunoglobulin G multiple myeloma, achieved partial and complete remissions, respectively, after conventional chemotherapy. They both received high-dose melphalan (200 mg/m2) with autologous stem cell transplantation (ASCT). Eighty-four and 78 days after ASCT, the patients underwent unrelated cord blood transplantation (CBT) following treatment with total-body irradiation (2 Gy), fludarabine (90 mg/m2), and melphalan (140 mg/m2). Neutrophil engraftment was attained on day +27 in patient 1 and day +15 in patient 2. Full donor chimerism of the marrow cells was confirmed. Regimen-related toxicity in both patients remained within grade I. Grades I and II acute graft-versus-host disease (GVHD) occurred in patients 1 and 2, respectively, but improved without steroid therapy. Both patients developed limited chronic GVHD of the skin but needed no treatment. The serum paraprotein level in patient 1 decreased further after ASCT and CBT but remained at minimally detectable levels. The serum and urine paraprotein levels in patient 2 remained below detectable limits. These results suggested that CBT with a reduced-intensity conditioning regimen after high-dose chemotherapy with ASCT is a new promising approach for the treatment of multiple myeloma.

Key words

Reduced-intensity Cord blood transplantation Multiple myeloma 

Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • Toshiki Yamada
    • 1
    • 2
  • Akira Tomonari
    • 1
  • Satoshi Takahashi
    • 1
  • Jun Ooi
    • 1
  • Tohru Iseki
    • 1
  • Yoko Shimohakamada
    • 1
  • Kashiya Takasugi
    • 1
  • Nobuhiro Ohno
    • 1
  • Fumitaka Nagamura
    • 1
  • Kaoru Uchimaru
    • 1
  • Arinobu Tojo
    • 1
  • Hisataka Moriwaki
    • 2
  • Shigetaka Asano
    • 1
  1. 1.Department of Hematology/Oncology, The Institute of Medical ScienceUniversity of TokyoMinato-ku, TokyoJapan
  2. 2.First Department of Internal MedicineGifu University School of MedicineGifuJapan

Personalised recommendations