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- greatly limits its use in multiple myeloma . Only 5 to 10 percent of multiple myeloma patients can have an
- allogeneic bone marrow transplantation because of their age and the lack of a matched donor.
- • Autologous transplantation—in which bone marrow or peripheral blood stem cells are removed from a patient
- before high-dose radiation or chemotherapy and then returned—is applicable for more patients because the age
- limit is higher (approximately 65 years) and a matched donor is unnecessary. The mortality rate for autologous
- transplantation is less than 10 percent.
- But there are two major problems with autologous transplantation for patients with multiple myeloma.
- First, it is difficult to destroy all the myeloma cells from the bone marrow even with high doses of
- chemotherapy and radiation. Second, it is difficult to remove the malignant myeloma cells from the bone
- marrow or blood before reinfusion. Using chemotherapy or monoclonal antibodies directed against myeloma
- cells (or both monoclonal antibodies and chemotherapy) may be helpful but is not yet practical.
-