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The role of high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) in the treatment of myeloma (MM) patients with severe and/or dialysis-dependent renal impairment remains uncertain. We report on the outcomes of 110 patients (median age 57 years) who had become dialysis-dependent pre-ASCT and who underwent a first ASCT between 1997 and 2017. Sixty-three (57%) patients had light chain MM. All patients required dialysis (94% hemodialysis and 6% peritoneal). Forty-four of 71 (62%) patients received bortezomib-based induction regimens and 42 (39%) patients had achieved at least a very good partial response (VGPR) pre-ASCT. Melphalan dosing was as follows: ≤140 mg/m 2 (82%), and >140 mg/m 2 (18%). The median PFS after ASCT was 35 months (95% CI: 21.5-42.2) and the median OS 102 months (95% CI: 70.4-129.1). At 1, 2, and 5 years after ASCT, 8% (95% CI 3-14%), 13% (6-20%), and 20% (12-29%) of patients, respectively, had achieved dialysis independence. In multivariate analyses of OS and PFS including age at ASCT, response at ASCT, and year of ASCT, younger age at ASCT and better response at ASCT (CR/VGPR/PR vs. MR/SD/progression) were significantly associated with better OS and PFS., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Autologous hematopoietic cell transplantation (auto-HCT) may be performed in multiple myeloma (MM) patients relapsing after a previous auto-HCT. For those without an adequate dose of stored stem cells, remobilization is necessary. This retrospective study included patients who, following disease relapse after the first auto-HCT(s), underwent stem cell remobilization and auto-HCT performed using these cells. There were 305 patients, 68% male, median age at salvage auto-HCT was 59 years. The median time to relapse after the first-line penultimate auto-HCT(s) was 30.6 months, the median follow-up after salvage auto-HCT 31 months. The 2- and 4-year non-relapse mortality (NRM) after the salvage auto-HCT was 5 and 9%, the relapse incidence 56 and 76%, respectively. Overall survival (OS) after 2 and 4 years was 76 and 52%, progression-free survival (PFS) 39 and 15%. In multivariable analysis an increasing interval between the penultimate auto-HCT and relapse was associated with better OS and PFS, later calendar year of salvage auto-HCT with better OS. In conclusion, salvage auto-HCT performed with cells remobilized after a previous auto-HCT was associated with acceptable NRM. The leading cause of failure was disease progression of MM, which correlated with a shorter interval from the penultimate auto-HCT to the first relapse., (© 2022. The Author(s).)

Autologous hematopoietic cell transplantation (AHCT) is a routinely used procedure in the treatment of adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and relapsed/refractory settings. Successful hematopoietic progenitor cell mobilization (HPCM) and collection are the rate limiting first steps for application of AHCT. In 2015, almost 1700 AHCT procedures have been performed for MM, HL and NHL in Turkey. Although there are recently published consensus guidelines addressing critical issues regarding autologous HPCM, there is a tremendous heterogeneity in terms of mobilization strategies of transplant centers across the world. In order to pave the way to a more standardized HPCM approach in Turkey, Turkish Society of Apheresis (TSA) assembled a working group consisting of experts in the field. Here we report the position statement of TSA regarding autologous HPCM mobilization strategies in adult patients presenting with MM and lymphoma., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Autologous hematopoietic cell transplantation (AHCT) is an established treatment option for adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and/or relapsed/refractory disease settings. Although there are recently published consensus guidelines addressing critical issues regarding autologous hematopoietic progenitor cell mobilization (HPCM), mobilization strategies of transplant centers show high variability in terms of routine practice. In order to understand the current institutional policies regarding HPCM in Turkey and to obtain the required basic data for preparation of a national positional statement on this issue, Turkish Hematology Research and Education Group (ThREG) conducted a web-based HPCM survey. The survey was designed to include multiple-choice questions regarding institutional practice of HPCM in adults presenting MM, HL, and NHL. The representatives of 27 adult HCT centers participated to the study. Here we report the results of this survey shedding light on the real-world experience in Turkey in terms of autologous HPCM mobilization strategies in patients presenting with MM and lymphoma., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The 2nd International Congress on Leukemia, Lymphoma and Myeloma (ICLLM) is a novel initiative of the Turkish Society of Hematology. The first congress was organized in Fethiye in May, 2007. After the success and positive impressions of the participants, the THD decided to organize the ICLLM every other year. The major focus was hematological malignancies, not only LLM, but also myeloproliferative disorders and myelodysplastic syndromes. The target audience was hematologists, oncologists and those involved in stem cell transplantation. The congress was held over 2 and a half days and attended by more than 350 participants from 25 different countries. The scientific program was shaped by 12 distinguished international speakers, who co-chaired and designed the sessions. The majority of the hematologists are caring for malignant patients and the Congress was a great opportunity for participants to get the latest update before the American Society of Clinical Oncology and American Society of Hematology 2009 official meeting. The rising interest and encouraging increase in the number of participants geared us to announce the organization of 3rd ICLLM in May 2011 in Istanbul.

Pericardial involvement, a rare complication of multiple myeloma (MM), is caused by amyloidosis, infections, bleeding abnormalities or plasma cell infiltration, usually at a late or terminal stage of the disease. Three cases of MM with pericardial involvement are reported here and discussed in the light of current literature. In a retrospective review of all patients with MM at two institutions, three cases of pericardial involvement were identified. In one case, we were able to obtain cytospin preparations of the pericardiocentesis fluid. In the remaining two patients, the pericardial biopsy specimen was obtained via a pericardial window. All patients had progressive dyspnea and signs of pericardial tamponade. The pericardiocentesis fluid showed infiltration with plasma cells in one of the three patients, who had a progressive and fatal course. In the second patient pericardial invasion was proven by biopsy and the third was diagnosed with a plasma cell leukemia but developed a pericardial effusion demonstrated by pericardial biopsy. All these three patients died of progressive disease without any response to chemotherapy and supportive measures. In conclusion, optimal treatment for malignant involvement of the pericardium by myeloma cells has not yet been established and is often fatal.

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Objective: This study aimed to conduct a retrospective evaluation of clinical findings on patients undergoing autologous hematopoietic stem cell transplantation. Materials and Methods: A total of 167 consecutive patients who were diagnosed with multiple myeloma (MM) and lymphoma and then underwent autologous hematopoietic stem cell transplantation (AHSCT) between August 2010 and May 2013 were included in our study. Demographic, disease, mobilization, apheresis, and transplantation data were reviewed from patient files. Results: In 121 patients (72%), mobilization was achieved solely with granulocyte colony stimulating factor (G-CSF). There was no relationship between peripheral CD34+ cell count and age, disease type, or previous treatment features. The total CD34+ cell count post-apheresis was 3.3 ± 3.1 x 106/kg. Only nine patients could not achieve successful mobilization with any regimen. The median day of neutrophil and platelet engraftment among the entire patient group was 11 days. As the number of CD34+ cells infused into patients increased, neutrophil and platelet engraftment time decreased. Conclusion: Mobilization was achieved in most MM cases and at least two-thirds of lymphomas using G-CSF alone. Age and body weight did not affect mobilization success. Clinicians should increase successful mobilizations on the first day of the apheresis and prescribe AHSCT at appropriate times to avoid excessive cycles of chemotherapy. [ABSTRACT FROM AUTHOR]

RBC transfusions should be based on Hb content of the products instead of units. As high as a 50-percent difference in Hb content can be encountered between two units. In this study, 500 mL of whole blood (WB)-generated RBCs according to their total Hb content was used to decrease the number of units ordered by using a new software called Hemosoft. Fifty-one con- secutive patients were enrolled for the study. The median age and male-to-female ratio were 38 (range, 16-69) and 28:23, respectively. Patients’ diagnoses were 38 acute leukemia, 11 lymphoma, and 2 multiple myeloma. When placing orders for RBCs, clinicians were asked to send the information about patient's actual body weight (ABW) and their actual and target Hb. The total blood volume of the recipient was calculated, and the aim was to find the best RBCs from the inventory to decrease two-unit orders to one unit, or four units to two or one unit, all done using Hemosoft. Posttransfusion Hb was checked 2 hours after transfusion. ABW and the median pretransfusion Hb level were 64 kg (range, 40-100) and 7.3 g per dL (5.6-9.8), respectively. 104 RBC units were ordered for 51 patients. In 49 (96.1%), the order was for two units and in 2 (3.9%) was for three units. Hemosoft successfully found a suitable match in 62.7 percent (32/51) of the orders. Actual number of RBCs transfused was two units (41.25) and one unit (58.8%), respectively. In total, 72 units were transfused with a reduction of 30 percent (72/104) from the original order. The median target Hb level was 9.3 g per dL (range, 7.0-11.3) and overall success rate to achieve it was 96.6 percent (range, 73.8-124.2). There was no impact of inventory size, but the ABW of the recipient was found significant to have a successful match unit (58.8 ± 11.0 kg vs. 75.0 ± 8.4 kg, respectively; p = 0.0001). We clearly demonstrated that the number of RBC transfusions could be minimized by the rational use of the Hb content of the units. Although the total numbers of patients who shall benefit from this approach seems to be limited, it allows us to use high-Hb-content units rationally by using an in-house blood-banking software. [ABSTRACT FROM AUTHOR]