What is the optimum technique for performing autografts?
Exposure to as little as 6 months of therapy with alkylating agents can affect stem cell collection and post-transplant hematologic recovery adversely. Stem cell-damaging agents such as melphalan and the nitrosoureas should either not be used in patients who may be candidates for autotransplantation, or stem cells should be collected before commencement of such therapy. Extensive local radiation—particularly to the pelvis—can also compromise stem cell collection. Unlike most hematologic malignancies, patients with myeloma may undergo more than 1 autograft—and sometimes more than 2.69 They may also benefit from chemotherapy for post-transplant relapse, an intervention that could result in prolonged pancytopenia. It is therefore important to collect enough stem cells before embarking upon the first autograft to ensure that possible future needs are taken care of. It is difficult to collect stem cells in patients with myeloma who have already undergone autotransplantation.70There is no pl
