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Myeloablative radiochemotherapy followed by reinfusion of purged autologous stem cells for Waldenström's macroglobulinaemia
Author(s) -
Dreger Peter,
Glass Bertram,
Kuse Rolf,
Sonnen Ruth,
Von Neuhoff Nils,
Bolouri Human,
Kneba Michael,
Schmitz Norbert
Publication year - 1999
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1999.01493.x
Subject(s) - medicine , stem cell , cyclophosphamide , autologous stem cell transplantation , total body irradiation , chemotherapy , gastroenterology , multiple myeloma , surgery , genetics , biology
Waldenström's macroglobulinaemia (WM) is an incurable lymphoproliferative disorder. The purpose of this study was to investigate the role of autologous peripheral blood stem cell transplantation (ASCT) for the treatment of WM. Seven patients (untreated or after first‐line therapy) with symptomatic WM underwent two or three cycles of Dexa‐BEAM chemotherapy + G‐CSF with stem cell harvesting and proceeded to total body irradiation and high‐dose cyclophosphamide followed by reinfusion of ex‐vivo B‐cell‐depleted stem cells. Engraftment was prompt, and procedure‐related deaths did not occur. A strong reduction or normalization of BM infiltration and serum IgM levels occurred in all evaluable patients, but immunofixation electrophoresis revealed persistent paraproteinaemia in five of them. With 3–30 months of follow‐up, all patients are alive without clinical or serological signs of disease progression. This pilot trial shows for the first time that high‐dose radiochemotherapy with purged stem cells is effective and may improve the course of patients with WM. In the majority of cases, however, complete eradication of the disease does not appear to be possible with ASCT alone.