Unrelated Cord Blood Transplantation Using a Reduced-Intensity Conditioning Regimen without Total Body Irradiation in Two Patients with Multiple Myeloma

Abstract

Reduced-intensity unrelated cord blood transplantation was performed on two patients (a 55-year-old woman and a 52-year-old man) with multiple myeloma that had progressed after high-dose chemotherapy (melphalan : 200 mg/m²) with autologous stem cell transplantation support. The conditioning regimen consisted of fludarabine (180 mg/m²) and busulfan (8 mg/kg) without total body irradiation. Tacrolimus was administered as a graft-versus-host disease prophylaxis. The engraftments were rapid (day +17 in patient 1 and day +26 in patient 2). Regimen-related toxicity was tolerable and acute graft-versus-host disease (grade I) appeared only in patient 2. Complete donor chimerism continued following the treatment and no disease progression was observed in the succeeding 12 months. These results demonstrate the feasibility and effectiveness of reduced-intensity cord blood transplantation after autologous stem cell transplantation in older patients.