Autologous Bone Marrow Transplant in Multiple Myeloma Patient With Bone Marrow Hematopoietic Stem Cell

D Santosa, Catharina Suharti, Edi Dharmana


Multiple myeloma (MM) is a malignancy with multiple complications such as recurrent bacterial infections, anemia, osteolytic lesions, bone marrow failure and decreased kidney function. In developed transplant center, the bone marrow transplant procedure is performed by the source of peripheral blood stem cells. Apheresis machine which is not always available in all Haematology and Oncology Centre in Indonesia, is required for harvesting stem cell from PBSC (peripheral blood stem cell). There are only a few reports on marrow-derived stem cells transplant from BM with a 24-hour storage in multiple myeloma cases. We report two cases with non-secretory myeloma stage III and IgG myeloma stage II (International Staging System). Both patients were treated with induction regimens CyBord until a complete remission. Once remission was achieved, an autologous bone marrow transplant procedures were performed. The source of haematopietic stem cells (HSCs) were harvested from bone marrow and stored for 24 hours at a temperature of 4◦ C. The complications were neutropenia, anemia, thrombocytopenia, mucositis, diarrhea, hair loss, and skin darkness. The HSCs grew well on day 12 and 23. After treatment in the isolation room, the patient’s condition improved and the patients were discharged.


myeloma; haematopoetic stem cells; bone marrow; autologous transplants


Drach J, Kaufmann H. New developments and treatment in multiple myeloma: new insights on molecular biology. Ann Oncol. 2002;13:43-7.

Anderson KC, Kyle RA, Dalton WS, et al. Multiple myeloma: new insights and therapeutic approaches. Hematology Am Soc Hematol Educ Program. 2000;1:147-65.

Bataille R, Haousseau JL. Monoclonal gammopathy of undetermined significance and the natural history of multiple myeloma. N Engl J Med. 1997;336:1657-64.

Osborne TR, Ramsenthaler C, de Wolf-Linder S, et al. Understanding what matters most to people with multiple myeloma: a qualitative study of views on quality of life. BMC Cancer. 2014;14:1-14.

World Health Organization. International Agency for Research on Cancer. Globocan 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. Cited from:

Key statistics about multiple myeloma. American Cancer Society, 2018. Cited from:

Myeloma - SEER Stat Fact Sheets 2013. Surveillance, Epidemiology, and End Results Program. Cited from:

Multiple Myeloma. American Cancer Society, 2018. Cited from:

Huang SY, Yao M, Tang JL, et al. Epidemiology of multiple myeloma in Taiwan: Increasing incidence for the past 25 years and higher prevalence of extramedullary myeloma in patients younger than 55 years. Cancer. 2007;110:896-905.

Bringhen S, Larocca A, Rossi D, et al. Efficacy and safety of once-weekly bortezomib in multiple myeloma patients. Blood. 2010;116:4745-53.

Hainsworth JD, Spigel DR, Barton J, et al. Weekly treatment with bortezomib for patients with recurrent or refractory multiple myeloma: A phase 2 trial of the Minnie pearl cancer research network. Cancer. 2008;113:765-71.

Kiba, T. Ito T, Nakashima T, et al. Bortezomib and dexamethasone for multiple myeloma: higher AST and LDH levels associated with a worse prognosis on overall survival. BMC Cancer. 2014;14:462. Doi: 10.1186/1471-2407-14-462.

Thomas ED. Bone marrow trnsplantation: a historical review. Medicina. 2000;33:209-18.

Watanabe H, Watanabe T, Suzuya H, et al.. Peripheral blood stem cell mobilization by granulocyte colony-stimulating factor alone and engraftment kinetics following autologous transplantation in children and adolescents with solid tumor. Bone Marrow Transplant. 2006;37:661-8.

Multiple Myeloma Research Foundation. Multiple Myeloma High-Dose Chemotherapy and Stem Cell Transplantation. p. 1-37. Cited from:

Decaux O, Lodé L, Minvielle S, Avet-Loiseau H. Genetic abnormalities in multiple myeloma: role in oncogenesis and impact on survival. Rev Med Interne. 2007; 28:677-81.

Kumar SK, Rajkumar SK, Dispenzieri A, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008;111:2516-20.

Tao ZF, Fu WJ, Yuan ZG, Wang DX, Chen YB, Hou J. Prognostic factors and staging systems of multiple myeloma. Chin Med J. (Engl). 2007;120:1655-8.

Reeder CB, Reece DE, Kukreti V, et al. Cyclophosphamide, bortezomib and dexamethasone induction for newly diagnosed multiple myeloma: high response rates in a phase II clinical trial. Leukemia. 2009;23:1337-41.

Kumar L. Haematopoietic stem cell transplantation: Current status. Natl Med J India. 2007;20:128-37.

Bryant A, Nivison-Smith I, Pillai ES, et al. Fludarabine Melphalan reduced-intensity conditioning allotransplantation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients. Bone Marrow Transplant. 2014;49:17-23.

Lemoli RM, D’Addio A. Conditioning regimen using Busulfan plus melphalan in hematopoietic stem cell transplantation : can this conditioning regimen be used in autologous or allogeneic transplantation for acute leukemia? Rev Bras Hematol Hemoter. 2011;33:172-8.

Shimoni A, Hardan I, Shem-Tov N, et al. Comparison between two fludarabine-based reduced-intensity conditioning regimens before allogeneic hematopoietic stem-cell transplantation: fludarabine/ melphalan is associated with higher incidence of acute graft-versus-host disease and non-relapse mortality and lower incidence of relapse than fludarabine/busulfan. Leukemia. 2007;21:2109-116.

Gyurkocza B, Sandmaier BM. Conditioning regimens for hematopoietic cell transplantation: one size does not fit all. Blood. 2014;124: 344-53.

Full Text: PDF


  • There are currently no refbacks.

Copyright (c) 2020 Acta Medica Indonesiana