Between 1992 and 1999 15 patients (pts.) suffering from multiple myeloma (M
RI) were treated with high-dose chemotherapy and consecutive autologous ste
m-cell transplantation (ASTx). 10/15 pts underwent two courses of ASTx (tan
dem- or double ASTx). So 25 ASTx were performed in these 15 pts. in total.
All pts. were under 60 a. of age. 13/15 pts. received 6 cycles of chemother
apy on an average according to the VAD-protocol (Vincristin, Adriamycin, De
xamethason). Mobilisation of peripheral hematopoietic stem cells was perfor
med with high-dose cyclophosphamide and hematopoietic growth-factors (CSFs)
. The conditioning protocol consisted of high-dose melphalan (200-225 mg/m(
2)) in 24/25 ASTx. In one single case total body irradiation (TBI) plus mel
phalan 140 mg/m(2) was used. 2/15 pts. died within 30 days from ASTx; one p
atient from interstitial pneumonia after TBI, and the other, who was in a v
ery advanced stage of his disease with multiple pretreatment courses before
ASTx. The overall survival (OS) was in the mean 68 months, the progression
-free survival (PFS) after ASTx 21 m respectively.
In pts. with MM high-dose melphalan (up to 225 mg/m(2)) without TBI plus AS
Tx is a safe and effective procedure when performed in the early course of
the disease.