Therapy and patients' outcome
| Patient no. . | Previous treatment . | Prior local irradiation . | HDT regimen* . | MIg response . | Follow-up, mo (since PBSC collection) . | Clinical response . |
|---|---|---|---|---|---|---|
| 1 | Cs, Imurel, plasma exchange, intravenous IgG | Left iliac wing (40 Gy) | HDM 140, HDM 140 + TBI 12 Gy | CR | 58 | Recovered walking and returned to normal life; residual distal motor after effects in lower limbs |
| 2 | None | None | HDM 200, HDM 140 + VP16 3 g + TBI 10 Gy | CR | 49 | Slight persistent distal hypoesthesia in lower limbs; cycling 15 km daily |
| 3 | Cytoxan (3 courses) | None | HDM 140 + oral busulfan 12 mg/kg | > 90% | 32 | Complete, except persistent arterial hypertension and need for cortisone supplementation |
| 4 | Plasma exchange | Left iliopubic area (40 Gy) | HDM 200 | CR | 25 | Residual distal motor after effects in lower limbs |
| 5 | None | Right iliac wing (40 Gy) | HDM 200 | CR | 12 | Complete (including normalization of nerve conduction studies) |
| Patient no. . | Previous treatment . | Prior local irradiation . | HDT regimen* . | MIg response . | Follow-up, mo (since PBSC collection) . | Clinical response . |
|---|---|---|---|---|---|---|
| 1 | Cs, Imurel, plasma exchange, intravenous IgG | Left iliac wing (40 Gy) | HDM 140, HDM 140 + TBI 12 Gy | CR | 58 | Recovered walking and returned to normal life; residual distal motor after effects in lower limbs |
| 2 | None | None | HDM 200, HDM 140 + VP16 3 g + TBI 10 Gy | CR | 49 | Slight persistent distal hypoesthesia in lower limbs; cycling 15 km daily |
| 3 | Cytoxan (3 courses) | None | HDM 140 + oral busulfan 12 mg/kg | > 90% | 32 | Complete, except persistent arterial hypertension and need for cortisone supplementation |
| 4 | Plasma exchange | Left iliopubic area (40 Gy) | HDM 200 | CR | 25 | Residual distal motor after effects in lower limbs |
| 5 | None | Right iliac wing (40 Gy) | HDM 200 | CR | 12 | Complete (including normalization of nerve conduction studies) |
HDT indicates high-dose therapy; MIg, monoclonal immunoglobulin; PBSC, peripheral blood stem cell; Cs, corticosteroids. Ig, immunoglobulin; TBI, total body irradiation; VP16, vepeside; CR, complete remission.
In all cases, supported with PBSC (collected as described in “Study design”), and granulocyte colony-stimulating factor (5 μg/kg/d) that was started on day 6 after transplantation and maintained until the neutrophil count was greater than 109/L. High-dose melphalan, either 140 mg/m2(HDM 140) or 200 mg/m2 (HDM 200) intravenously.