AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN MULTIPLE-MYELOMA - A SINGLE-CENTER EXPERIENCE OF 23 PATIENTS

We report the complications and outcome of high-dose melphalan and TBI combined with ABMT used in the treatment of multiple myeloma at a sin gle centre. Twenty-three patients, aged 65 years or less, who underwen t the procedure are reviewed. AII had chemosensitive disease. Response to ABMT assessed at 3 months showed 75% of evaluable patients to have further tumour cytoreduction of at least 50%, with 24% of patients wh o entered ABMT with residual disease eventually achieving CR. There wa s one toxic death. The overall survival is 60% and the progression-fre e survival is 49.8% at a median follow-up time of 17 months. Relapse o r disease progression has occurred in 27% of patients, of whom half ha ve died. No significant prognostic factors affecting survival were fou nd although those patients with IgG myeloma had a better outcome. Pati ents transplanted in first plateau appeared to do significantly better if they had been resistant to their first-line chemotherapy but had t hen responded to further conventional chemotherapy (p = 0.029).