Autologous bone marrow transplantation therapy for multiple myeloma

Anderson, Kenneth C.; Barut, Bruce A.; Ritz, Jérôme; Freedman, Arnold S.; Nadler, Lee M.

doi:10.1111/j.1600-0609.1989.tb01510.x

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…Autologous hematopoietic stem cell transplantation has become an integral part of multiple myeloma treatment1–4. Usually a hematopoietic stem cell transplant is performed with a minimum of 2.5 to 3× 10 6 peripheral blood CD34 cells per kilogram of body weight5.…”

Section: Introductionmentioning

confidence: 99%

Multiple myeloma patients receiving large volume leukapheresis efficiently yield enough CD34+ cells to allow double transplants

Zubair

Rymer

Young

et al. 2009

J of Clinical Apheresis

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Current protocols for myeloma patients require more than one autologous transplant. We performed a retrospective study to determine cost effectiveness of large volume leukapheresis (LVL) compared to standard volume leukapheresis (SVL) collection when two transplants are required. We evaluated 87 patients who underwent a cumulative total of 260 LVL and SVL collections. The median product volume per collection was 356ml for LVL and this was significantly higher than the median product volume per collection for SVL (median 149.5ml, p <0.001). The median total CD34+ cell yield/kg was 6.4 × 10 6 for LVL and 5.2 ×10 6 for SVL. This difference was statistically significant (p = 0.005). Since the target CD34+ cell dose for a single transplant was 3 × 10 6 /Kg at our institution, overall the LVL yields enough CD34+ cells that could allow for two transplants. Therefore, more patients in the LVL group were able to undergo a potential 2 nd transplant. Because of the reserved cells for a second transplant, LVL patients received significantly less CD34+ cell/Kg per transplant than the patients in SVL group (p = <0.001). As a result, LVL group had statistically significant but clinically insignificant delay in neutrophil (p = <0.001) and platelet (p = 0.02) engraftments. Additionally, using LVL instead of SVL to collect ≥6 × 10 6 /Kg CD34+ cells may potentially save $7,497/patient. We therefore conclude that LVL is the method of choice for collection of multiple myeloma patients when two transplants are anticipated.

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Section: Introductionmentioning

confidence: 99%

Multiple myeloma patients receiving large volume leukapheresis efficiently yield enough CD34+ cells to allow double transplants

Zubair

Rymer

Young

et al. 2009

J of Clinical Apheresis

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“…The Mucositis Study Group of the Multinational Cancer Support Editorial Process: Submission:02/16/2020 Acceptance:07/14/2020 Care Association and the International Society of Oral Oncology (MASCC/ISOO) has proposed clinical practice guidelines for the management of OM that include palliative care and assumed future targeted therapeutic interventions (Lalla et al, 2014). Several studies have investigated alternative topical interventions that may reduce the symptoms and severity of OM, including allopurinol, benzydamine (Lalla et al, 2014;Tsavaris et al, 1991;Abbasi et al, 2007), chlorhexidine (Kin-Fong and Ka Tsui, 2006;Diaz-Sanches et al, 2015;Dodd et al, 2000), sucralfate (Dodd et al, 2003), diphenhydramine, morphine (Cerchietti et al, 2003), phenytoin (Baharvand et al, 2010;Baharvand et al, 2015), glutamine (Dodd et al, 2000;Anderson et al, 1989), aluminum hydroxide, palifermin, and propolis (Akhavankarbassi et al, 2016). Still, no evidence supports a standard systemic or topical therapy or preventive measure for OM induced by CT and/or RT.…”

Section: Topical Treatment Of Oral Mucositis In Cancer Patients: a Systematic Review Of Randomized Clinical Trialsmentioning

confidence: 99%

“…Five studies had a low RoB in all evaluated domains (Miranzadeh et al, 2015;Baharvand et al, 2010;Baharvand et al, 2015;Sarvizadeh et al, 2015;Cabrera-Jaime et al, 2018) and could be considered more reliable studies (Figure 2). "Unclear risk," defined as insufficient or missing data that difficult the assessment of the original study, occurred in the "random sequence generation" and "allocation concealment" domains of 11 (Dodd et al, 2003;Yen et al, 2012;Cerchietti et al, 2003;Sprinzl et al, 2001;Erden and Ipekcoban, 2017;Lin et al, 2015;Porta et al, 1994;Erdem et al, 2014;Limaye et al, 2013;Rothwell and Spektor, 1990;Wadleigh et al, 1992) and 12 studies (Yen et al, 2012;Cerchietti et al, 2003;Anderson et al, 1989;Sprinzl et al, 2001;Erden and Ipekcoban, 2017;Porta et al, 1994;Satheeshkumar et al, 2010;Vayne-Bossert et al, 2010;Erdem and Güngörmüş, 2014;Wadleigh et al, 1992;Hejna et al, 2001;Mansouri et al, 2012), respectively. "High risk" in the "blinding of participants and personnel" domain occurred in six studies (Cerchietti et al, 2003;Sprinzl et al, 2001;Lin et al, 2015;Satheeshkumar et al, 2010;Limaye et al, 2013;Hejna et al, 2001).…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials

Sant’Ana

Normando

Toledo

et al. 2020

Asian Pac J Cancer Prev

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Background and Purpose: Evidence-based protocols of topical therapy for oral mucositis (OM) induced by chemoradiotherapy (CRT) are continuously established and updated. Thus, the present systematic review aims to evaluate the scientific literature in terms of effectiveness of topical treatment of OM in cancer patients undergoing CRT. Materials and Methods: This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist. Randomized clinical trials were identified through electronic database searches on CINAHL, Cochrane Library, LILACS, Livivo, PubMed, SCOPUS, and Web of Science. Grey literature was also assessed on Google Scholar, Open Grey, and ProQuest. The risk of bias in the included studies was assessed by the Cochrane Collaboration Risk of Bias Tool. Results: Twenty-three randomized clinical trials (n=1169 patients) met the inclusion criteria. Twenty-three different topical agents were examined and categorized into five groups: analgesics (30.4%), natural agents (21.7%), other topical agents (21.7%), antimicrobial agents (17.4%), and growth factors (8.8%). Of the included studies, 50% presented a resolution of OM within 14 days. Topical natural agents yielded good results with average resolution time of 3–7 days. The included studies generally demonstrated that patients treated with mouthwashes presented superior benefits compared to the control, depending on OM severity. Conclusion: Topical agents effectively reduced the severity of OM lesions and pain intensity in patients receiving chemoradiotherapy, although the effects varied by agent type. However, the heterogeneity in the results of these topical intervention studies underscores the need for standardized clinical trial methodologies. Clinical Relevance: Topical agents were effective in patients with severe OM lesions receiving chemoradiotherapy and are a good alternative of home care in relation to pain control, reduction of inflammation and consequent improvement in quality of life.

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“…For example, given that high-dose therapy and autologous BM transplantation achieved remarkable extent and frequency of response, we early on examined whether cocktails of MoAbs (CD 10, CD20, PCA-1) could purge MM cells from autografts ex vivo prior to autologous BM transplantation. 7 Although effective at purging 2–3 logs of MM cells, this strategy had little impact on overall outcome, likely due to residual systemic tumor burden. T-cell (CD6)-directed MoAbs were used to purge T cells from allogeneic BM grafts to abrogate graft versus host disease.…”

Section: Monoclonal Antibodies and Immune-based Therapiesmentioning

confidence: 99%

The 39th David A. Karnofsky Lecture: Bench-to-Bedside Translation of Targeted Therapies in Multiple Myeloma

Anderson

2012

JCO

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120

101

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Multiple myeloma (MM) is a remarkable example of rapid bench-to-bedside translation in new drug development. The proteasome inhibitor bortezomib and immunomodulatory drug lenalidomide targeted MM cells in the bone marrow (BM) microenvironment to overcome conventional drug resistance in laboratory and animal models and were rapidly translated into clinical trials demonstrating their efficacy in patients with relapsed and then newly diagnosed MM, with a doubling of the median survival as a direct result. The future is even brighter. First, immune-based therapies are being developed (eg, elotuzumab monoclonal antibody [MoAb]; CD138DM immunotoxin; MM cell–dendritic cell vaccines; CD138, CS-1, and XBP-1 peptide vaccines; anti-17 MoAb; and other treatments to overcome causes of immune dysfunction). Second, promising next-generation agents target the MM cell in its microenvironment (eg, deubiquitinating enzyme inhibitors; chymotryptic [carfilzomib, Onyx 0912, MLN 9708] and broader [NPI-0052] proteasome inhibitors; immunoproteasome inhibitors; and pomalidamide). Moreover, agents targeting bone biology (eg, zoledronic acid, anti–DKK-1 MoAb, anti–B-cell activating factor MoAb and bortezomib, Btk inhibitor) show promise not only in preserving bone integrity but also against MM. Third, rationally based combination therapies, including bortezomib with Akt, mammalian target of rapamycin, or histone deacetylase inhibitors, are active even in bortezomib-refractory MM. Finally, genomics is currently being used in the definition of MM heterogeneity, new target discovery, and development of personalized therapy. Myeloma therefore represents a paradigm for targeting the tumor in its microenvironment, which has already markedly improved patient outcome in MM and has great potential in other hematologic malignancies and solid tumors as well.

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Autologous bone marrow transplantation therapy for multiple myeloma

Cited by 7 publications

References 48 publications

Multiple myeloma patients receiving large volume leukapheresis efficiently yield enough CD34+ cells to allow double transplants

Multiple myeloma patients receiving large volume leukapheresis efficiently yield enough CD34+ cells to allow double transplants

Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials

The 39th David A. Karnofsky Lecture: Bench-to-Bedside Translation of Targeted Therapies in Multiple Myeloma

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