Study Compares Stem Cell Transplants for Myeloma

For younger patients, a transplant from a compatible donor boosts survival

By Amanda Gardner
HealthDay Reporter

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WEDNESDAY, March 14 (HealthDay News) -- Younger patients diagnosed with the blood cancer myeloma survived longer if they received a stem cell transplant from themselves that was followed by one from a matched sibling -- rather than receiving two transplants from themselves, researchers report.

However, while the protocol may be a good treatment alternative for some patients, they represent only a fraction of the total who develop myeloma, outside experts said.

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"It's a good study and it gives important perspective, and it will be useful for some patients but it's a small minority of myeloma patients," said Dr. Marshall Lichtman, executive vice president of research and medical programs at the Leukemia & Lymphoma Society.

He was not involved in the study, which was led by Dr. Benedetto Bruno of the University of Turin, Italy, and published in the March 15 issue of the New England Journal of Medicine.

Myeloma (also known as multiple myeloma) is a cancer of the blood's plasma cells, which are a type of white blood cell present in the bone marrow.

According to background information in the study, high-dose chemotherapy followed by a transplant of the patient's own stem cells is the standard of care for newly diagnosed patients under the age of 65.

"The transplant was rescuing the patients after life-threatening chemotherapy. You need that intensity to kill off the tumor, but it also kills off normal blood and immune-forming cells," Lichtman explained. "The patient needs to be replenished."

But sometimes transplanted cells from the patient still don't recognize the cancerous cells as foreign and fail to attack them as they should, allowing the disease a chance to recur.

However, when stem cells come from a compatible outside donor (such as a sibling), it can result in "graft-versus-myeloma" effect, meaning the new immune cells attack and kill off the myeloma cells. Lower relapse rates and longer remissions have been reported in patients receiving stem-cell transplants from other donors compared to transplants using the patients own stem cells.

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