Multiple myeloma

BMJ 1994;308:1715 (25 June)

Letters

Multiple myeloma

EDITOR, - In their detailed review on developments in the treatmentof multiple myeloma, Ian C M MacLennan and colleagues brieflydiscussed the results of allogeneic bone marrow transplantation,in particular mentioning the reported high mortality relatedto the procedure.¹ Our own experience of allogeneic bone marrowtransplantation for myeloma is different.

Since 1989 we have undertaken six allogeneic transplant operationsusing sibling donors for myeloma in patients at various stagesof their disease (three in first plateau; two in second plateau,one patient with primary refractory disease). All patients receivedconditioning with total body irradiation (12 Gy in six fractions)and either cyclophosphamide (120 mg/kg, one patient) or melphalan(110 mg/m², five patients). Additional radiotherapy was alsogiven to major lytic lesions identified by skeletal survey.All patients received cyclosporin and a short course of methotrexateas prophylaxis against acute graft versus host disease.² Despitea high median . . . [Full text of this article]