Understanding Stem Cell Transplant IMF International Myeloma Foundation 12650 Riverside Drive, Suite 206 North Hollywood, CA 91607 USA Telephone: 800-452-CURE (2873) (USA & Canada) 818-487-7455 Fax: 818-487-7454 TheIMF@myeloma.org www.myeloma.org 03/07
David Vesole Brian Durie 2007, International Myeloma Foundation, North Hollywood, California
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M 4 M ISS 2 2M 3.5g/dl 2 3.5mg/dl 3.5 g/dl 2 3.5 mg/dl 3.55.5g/dl 2 5.5mg/dl M "" 5 10 20 6 7
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HLA "" HLA (MUD) (HLA) 100 " " VAD VDD IMF( ) 65 10 11
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PR()VGPR CR 50PR 50 50 "" "" 20 50 100 4 14 15
Neupogen Neulasta Leukine [PBSC] 1) 2) 1) 2) 10 16 17
"Tylenol " 2 DMSO 10 CD34+ CD34+ kg 200 CD34+ CD34+ CD34+ 2 kg 400 CD34+ 18 19
AMD-3100 ("Mozobil ") 200mg (mg/) 2 2 1 {} DMSO 4 10 14 20 21
3 2,3 2 22 23
4 36 QOL 24 25
2 6 2 VGPR CR "Quadramet " Sm-153 "" GVHD 4 GVHD 26 27
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IMF IMF 30 31
50 18 36 2,3 95 99 1014 "" QOL 6 32 33
1 34 35
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IMF 1 2 IMF. D. 75,000 100,000 20,000 IMF 1990 33 3 IMF 4 IMF 185,000 IMF IMF IMF 38 39
IMF IMF InfoPack IMF http://www.myeloma.org IMF 24 : 800-452-CURE (2873) IMF IMF 100 IMF IMF http://www.myeloma.org/listserve.html Myeloma Minute BANK ON A CURE DNA ISS Myeloma Matrix IMF IMF Myeloma Today 40 41
DNA HLA (NMDP) 13 14g/dl 10g/dl 2 102 2 2 902 CD34+ CD34+ 42 43
CSF() "Neupogen" "Neulasta""Leukine" CR: CR CR ISS 20 M M M M M M PBSC "" PBSC PBSC CR CR 44 45
2 2 36 VGPR) 100 M 90 3 1. Attal M, Harrousseau JL, Stoppa AM, et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Francais du Myelome. N Engl J Med. 1996;335:91-97. 2. Fermand JP, Ravaud P, Chevret S, et al. High-dose therapy and autologous peripheral blood stem cell transplantation in multiple myeloma: up-front or rescue treatment? Results of a multicenter sequential randomized trial. Blood. 1998;92:3131-3136. 3. Barlogie B, Jagannath S. Desikan KR< et al. Total therapy with tandem transplants for newly diagnosed multiple myeloma. Blood. 1999;93:55-65. 4. Child JA, Morgan GJ, Davies FE, et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. N Engl J Med. 2003;348:1875-1883. 5. Attal M, Harousseau JL, Facon T, et al. Single versus double autologous stem-cell transplantation for multiple myeloma. N Engl J Med. 2003;349:2495-2502. 6. Fassas AB, Van Rhee F, Tricot G. Predicting long-term survival in multiple myeloma patients following autotransplants. Leuk Lymphoma. 2003;44:749-758. 7. Blade J. Transplantation for multiple myeloma: who, when, how often? High-dose therapy in multiple myeloma. Blood. 2003;15:3469-3477. 8. Barlogie B, Tricot G, Anaissie E, et al. Thalidomide and menatopoietic-cell transplantation for multiple myeloma. N Engl J Med. 2006;354:1021-30. 9. Cavo M, Baccarani M. The changing landscape of myeloma therapy. N Engl J Med. 2006;354:1076-78. 10. Barlogie B, Tricot G. Complete response in myeloma: a Trojan horse? Blood. 2006;108:2134. IMF http://www.myeloma.gr.jp/ IMF http://myeloma.org/pdfs/u-stemcell_d2_web.pdf 46 47