Non-myeloablative allogeneic transplantation ('microallograft') for refractory myeloma after two preceding autografts: Fesibility and efficacy in a patient with active aspergillosis

S. Singhal*, A. Safdar, K. Y. Chiang, K. Godder, F. Van Rhee, F. Garner, B. Foster, D. Dubovsky, P. J. Henslee-Downey, J. Mehta

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

A 59-year-old man with a 4-year history of light chain myeloma relapsing after two preceding autografts and salvage therapy with thalidomide underwent a peripheral blood stem cell (PBSC) transplant from his HLA-identical sister after conditioning with 100 mg/m2 melphalan. Graft-versus-host disease (GVHD) prophylaxis comprised cyclosporine. Despite pulmonary infiltrates and sinusitis at the time of the allograft, it was decided to proceed with the transplant because the myeloma was refractory and rapidly progressive. Sputum cultures obtained 2 days before the allograft grew Aspergillus fumigatus 2 days post transplant. A fumigatus grew repeatedly on specimens obtained post transplant. Prompt hematologic recovery was seen with full donortype chimerism. The fungal infection subsided gradually on a combination of amphotericin B lipid complex and itraconazole. A second aliquot of donor PBSC was infused electively on day +42 to induce graft-versus-myeloma. Complete remission of the myeloma was achieved by 75 days post transplant. No acute GVHD was seen. No chronic GVHD was seen at 16 weeks when he received the third PBSC infusion. He is currently alive and well in remission 9 months post transplant. This case demonstrates the safety and potential usefulness of allogeneic PBSC transplantation with reduced-intensity conditioning in patients with markedly compromised performance status.

Original languageEnglish (US)
Pages (from-to)1231-1233
Number of pages3
JournalBone Marrow Transplantation
Volume26
Issue number11
DOIs
StatePublished - 2000

Keywords

  • Allogeneic blood stem cell transplantation
  • Amphotericin B lipid complex
  • Aspergillosis
  • Microallograft
  • Multiple myeloma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint

Dive into the research topics of 'Non-myeloablative allogeneic transplantation ('microallograft') for refractory myeloma after two preceding autografts: Fesibility and efficacy in a patient with active aspergillosis'. Together they form a unique fingerprint.

Cite this