A small French study suggests that myeloma patients may benefit from a “mini” donor stem cell transplant in the absence of a suitable related donor.Results of the study showed that the estimated two-year overall and progression-free survival rates were similar between myeloma patients who received stem cells from a related donor and patients who received stem cells from an unrelated donor.
Multiple myeloma is cancer of the plasma cells in bone marrow.Plasma cells help your body fight infection by producing proteins called antibodies.In multiple myeloma, plasma cells grow out of control in the bone marrow and form tumors in the areas of solid bone.The growth of these bone tumors makes it harder for the bone marrow to make healthy blood cells and platelets.Multiple myeloma mainly affects older adults.Past treatment with radiation therapy raises the risk for this type of cancer.
In a donor, or allogeneic, stem cell transplantation procedure, thepatient receives high-dose chemotherapy followed by an infusion of stem cells from a matched donor in order to replace the cells that were destroyed by the chemotherapy.These stem cells can be taken from either a related donor, such as a sibling or other relative, or from an unrelated donor.
Once transfused into the patient, the donor stem cells eventually mature into immune cells which can recognize the patient’s cancer cells as abnormal cells and destroy them. This phenomenon is known as the graft-versus-tumor, or graft-versus-myeloma, effect.
In an autologous stem cell transplantation, a patient’s own stem cells are collected before receiving high-dose chemotherapy and then returned to the patient following chemotherapy.The graft-versus-tumor effect does not occur for patients receiving an autologous stem cell transplant because the patient’s own cells are unable to recognize and destroy the cancerous cells.
Although donor stem cell transplantation gives myeloma patients a better chance for a cure than autologous stem cell transplantation, it also carries a greater risk of complications. One of the most serious transplant-related complications is a condition called graft-versus-host disease (GVHD), in which white blood cells from the donor recognize the recipient’s cells as foreign and attack them.
To decrease the transplant-related complications and death rate, the French study looked at a new procedure known as non-myeloablative, or “mini,” donor stem cell, which uses lower doses of chemotherapy and radiation than standard donor stem cell transplants.This makes the procedure less toxic and more tolerable, which is particularly important for myeloma patients who are elderly or have concurrent illnesses.
In the study’s most recent follow-up, 61 percent of patients in the related-donor group and 53 percent of patients in the unrelated-donor group were still alive. Of these patients, those in the related-donor group and unrelated-donor group, respectively, were in complete remission (79 percent versus 56 percent), partial remission (21 percent versus 22 percent), or progressive disease (0 percent versus 22 percent).
The researchers determined that patients in the related-donor group and the unrelated-donor group, respectively, had similar two-year progression-free survival (44 percent versus 42 percent) and overall survival rates (66 percent versus 59 percent).
The relapse rate was higher in patients with unrelated donors (40 percent versus 52 percent).The rate of acute GVHD, which occurs within 100 days of the transplant, was lower in patients in the related-donor group (17 percent) than in patients in the unrelated-donor group (47 percent).
In contrast, the rate of chronic GVHD, which occurs at least 100 days after the transplant, was similar between the two treatment groups (24 percent versus 30 percent).
Currently, autologous stem cell use is growing in use and acceptance to treat musculoskeletal conditions.Research into the use of stem cell to treat neurologic and immune disorders is increasing, and this French study adds to the growing promise of stem cell therapy.
To learn more about this French study,click here.
Dennis M. Lox, MD, has been sucessfully preforming stem cell therapy for several years. Dr. Lox is located in the Tampa bay area in Clearwater, Florida
Information contained in this blog is intended for educational purposes only and not for medical diagnosis or treatment.If you have a medical concern or issue, please consult with your physician.