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Five patients with high risk multiple myeloma not responsive to standard chemotherapy were treated by high-dose chemotherapy (Melphalan, Cyclophosphamide) (HDC) and total body irradiation (TBI) followed by autografting with blood stem cells. These cells were previously collected by leukaphereses from eight to twelve occasions during hematopoietic recovery following profound aplasia induced by each course of intensive chemotherapy (Vincristine, Adriamycin, Cyclosphosphamide, Prednisone) when the patient reached a neutrophil count of 1,000/microliters and a platelet count of 100,000/microliters. No patients had evidence of tumor plasmacells in leukaphereses products using cytology, immunocytochemistry and immunofluorescence. At this time the patient 5 is not evaluable because of the short follow-up. One died at day 30 from heart failure. All living patients achieved a complete remission which persisted at a follow-up of 300, 261 and 136 days. Autologous blood derived hematopoietic stem cells induced successful and sustained engraftment in all living patients. Our results indicate the feasibility of this therapeutic approach over allogenic or autologous bone marrow transplantation in selected patients with high tumour mass multiple myeloma.

In S. Camillo Hospital, Rome, the Apheresis Center (CNTS-CRI) and the Haematological Division, Authors treated 17 patients affected by haematologic malignances and solid tumours with leukoapheresis procedures for PBSC collection. Nine patients were treated with continuous-flow cell separator Dideco Vivacell, performing a total of 50 collection procedures. Mean values of total collected NC and MNC were 6.5 x 10(9) and 5.5 x 10(9), with a mean recovery 24% and 52%. Authors took patient's blood samples during the procedure, in order to analyze the MNC collection and to optimize the separation efficiency. Haemopoietic reconstitution values of the eight patients submitted to APBSCT showed the effectiveness of our method of cell collection.