Blood Journal
Leading the way in experimental and clinical research in hematology

Graft-versus-myeloma effect: proof of principle

  1. G Tricot,
  2. DH Vesole,
  3. S Jagannath,
  4. J Hilton,
  5. N Munshi, and
  6. B Barlogie
  1. Division of Hematology/Oncology, University of Arkansas for Medical Sciences, Little Rock, USA.

Abstract

The presence of a graft-versus-tumor effect has been well established in leukemia but not in multiple myeloma. A 40-year-old patient with myeloma refractory to standard chemotherapy and autologous transplantation received a matched unrelated T-cell-depleted transplant after conditioning with fractionated total-body irradiation, thiotepa, and cyclophosphamide. This procedure resulted in a transient and incomplete response with evidence of rapidly progressive disease within 2.5 months posttransplantation. The patient then received a small number of donor peripheral blood (PB) mononuclear cells (CD3 cells 1.2 x 10(6)/kg) without any further cytotoxic therapy. A complete remission was attained, lasting now for more than 14 months. The procedure was associated with severe acute and subsequently limited chronic graft- versus-host disease (GVHD). This report provides the first direct evidence of a graft-versus-myeloma effect after allogenic transplantation.