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| Extramedullary vs medullary relapse after autologous or allogeneic hematopoietic stem cell transplantation (HSCT) in multiple myeloma (MM) and its correlation to clinical outcome |
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| Author(s): Zeiser R, Deschler B, Bertz H, Finke J, Engelhardt M |
| Source: BONE MARROW TRANSPLANTATION Volume: 34 Issue: 12 Pages: 1057-1065 Published: DEC 2004 |
| Times Cited: 15 References: 41 |
| Abstract: Risk-adapted treatment of multiple myeloma (MM) includes autologous (auto-) and allogeneic (allo-) hematopoietic stem cell transplantation (HSCT). Case reports on extramedullary (EM) compared to bone marrow (BM) relapse after HSCT suggest a dismal prognosis. We compared the outcome of 78 MM patients relapsing after auto- (group A: n=53) or allo- (group B: n=25) HSCT, stratified into BM (64 patients) vs EM (14 patients) relapse. The relapse-specific groups were also compared with respect to risk factors, including age, beta2-microglobulin, pretreatment, cytogenetics and stage. EM relapse sites were lungs (5), soft tissue (4), pericardium (2), bone (1), skin (1) and CNS (1). As of May 2004, the overall (OS) and progression-free (PFS) survival after HSCT in patients relapsing from EM sites was not significantly different from BM relapse patients, both after auto- and allo- HSCT. Although MM patients relapsing from EM sites after allo- HSCT used to be regarded as having few therapeutic options, we observed encouraging responses to donor lymphocyte infusions (DLI). Treatment responses to DLIs were observed in 5/9 (56%) BM relapse patients, and in 3/4 (75%) EM relapse patients. These observations suggest that EM relapse after HSCT is common and needs an individualized diagnostic and therapeutic approach in MM during clinical follow-up after HSCT. |
| Document Type: Article |
| Language: English |
| Reprint Address: Engelhardt, M (reprint author), Univ Freiburg, Med Ctr, Dept Hematol Oncol, Hugstetterstr 55, D-79106 Freiburg, Germany |
Addresses:
1. Univ Freiburg, Med Ctr, Dept Hematol Oncol, D-79106 Freiburg, Germany |
| Publisher: NATURE PUBLISHING GROUP, MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND |
| Subject Category: Biophysics; Oncology; Hematology; Immunology; Transplantation |
| IDS Number: 875JA |
| ISSN: 0268-3369 |
| DOI: 10.1038/sj.bmt.1704713 |
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