Stem Cell Transplant in Multiple Myeloma – Experience of a Single Tertiary Care Centre – Dr. Chirag Shah (Diplomate American Board of Medical Oncology, Hematology)
Apollo hospital Ahmedabad started Stem Cell Transplant services for haematological diseases in year 2007. Total transplants done till date are 74 (Autologous-52, Allogeneic22). Largest number in private hospital of Gujarat. Diseases treated so far: Myeloma, Lymphoma, Acute Leukemia – AML and ALL, CML, MDS , Neuroblastoma, THALASSEMIA, Aplastic anemia.
Myeloma Transplant Experience:
Total 31 patients.
Safe:
100 % successful discharge rate. Patients with high creatinine (3 patients), other comorbidities (diabetes, hypertension, coronary artery disease with stent), age over 60 (six patients) also treated. Majority patients in stage 3 by ISS criteria. 8 patients of relapsed myeloma.
Indication:
First line – within 3-6 months after diagnosis in 75% patients. Recommended by all international guidelines, such as NCCN.org, American cancer society.
Effective:
Over 70% CR (complete remission) – all these patients remain treatment free, disease free. 9 patients who have already crossed over 3 years, remain treatment free. 1 of these patients has crossed 5 years.
Convenient:
Most of these patients are requiring minimal follow up – once every 3 to 6 months. Suitable for patients coming from far distance and international patients.
Cost Effective:
Approximately Rs 5 lac.
Standard:
75% of our patients have been treated with standard recommended dose of 200 mg/m2 for melphalan. Elderly over age 60, and those withraised creatinine received 140 mg/m2 as per standard international practise.
