THE USE OF AN EXPANDED CIRCULATING HEMATOPOIETIC PROGENITOR-CELL POOLASSOCIATED WITH BONE-MARROW FIBROSIS FOR THE SUPPORT OF AUTOLOGOUS TRANSPLANTATION IN IGD MULTIPLE-MYELOMA

Leukoerythroblastosis and myelofibrosis were observed at presentation in a patient with IgD myeloma. Interestingly, a 1000-fold increase in peripheral blood progenitor cells (PBPC) was found in the steady state without signs of any underlying myeloproliferative disorder. The myel oma was resistant to conventional therapy, The expanded PBPC were coll ected in the steady state and used to support two consecutive myeloabl ative courses. A complete remission of the myeloma was achieved, with resolution of myelofibrosis. Furthermore, the unprimed PBPC expanded a s a result of myelofibrosis, provided a sustained hematopoietic recons titution. This indicated that their hematopoietic potential was equiva lent to that of PBPC mobilized by chemotherapy or growth factors.