Abstract

Objective: Initial assessment of the feasibility and effectiveness of autologous stem cell transplantation in multiple myeloma patients.

Methods: Descriptive case series. Four multiple myeloma patients were treated with 4 cycles of VTD regimen (Velcade, Thalidomid, Dexamethasone) followed by high - dose chemotherapy with melphalan and autologous hematopoietic stem cell transplantation.

Results: Four patients were in the age group of 54 - 61, classified as IgG subtype, with medium to high risk, in stages II - III. One - quarter achieved partial remission, while three - quarters achieved very good partial remission. The average volume of harvested stem cells was 722 ± 53.2ml. The average CD34+ stem cell dose infused was 8.0 ± 2.8 (x106/kg). The median time to neutrophil engraftment was 11.3 ± 1.3 days, with the lowest neutrophil count: 0.02 ± 0.01 G/L. The median time to platelet engraftment was 10 ± 1.6 days, with the lowest platelet count: 19.5 ± 9.7 G/L. The average duration of G-CSF usage was 7.8 ± 1.3 days. All four patients required platelet transfusions were under post- transplant. All patients received eltrombopag. The average isolation period was 14 ± 2.2 days, ranging from 11 to 15 days. The most common complications during transplantation were nausea, vomiting (4/4), diarrhea (3/4), and febrile neutropenia (3/4). All four patients used intravenous antibiotics, one patient was required with antifungal treatment for 12 days. Evaluation after 3 months of autologous hematopoietic stem cell transplantation, all patients in the stydy achieved complete remission.

Conclusion: The VTD regimen combined with high dose melphalan and autologous hematopoietic stem cell transplantation is relatively safe and initially shows good effectiveness in the treatment of multiple myeloma.