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BioMed Research International
Volume 2013 (2013), Article ID 321762, 7 pages
Research Article

Total Marrow Irradiation as Part of Autologous Stem Cell Transplantation for Asian Patients with Multiple Myeloma

1Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
2Department of Nursing, Oriental Institute of Technology, New Taipei City 220, Taiwan
3Department of Biotechnology, School of Healthy Technology, Ming Chuan University, Taipei 111, Taiwan
4Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banqiao District, New Taipei City 220, Taiwan
5School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100, Taiwan
6Physical Therapy Center, National Taiwan University Hospital, Taipei 100, Taiwan
7Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
8Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan

Received 5 June 2013; Revised 6 August 2013; Accepted 7 August 2013

Academic Editor: Maria F. Chan

Copyright © 2013 Shih-Chiang Lin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


To compare the outcomes of melphalan 200 mg/m2 (HDM200) and 8 Gy total marrow irradiation (TMI) delivered by helical tomotherapy plus melphalan 140 mg/m2 (HDM140 + TMI 8 Gy) in newly diagnosed symptomatic multiple myeloma (MM) Asian patients. Between 2007 and 2010, nine consecutive myeloma patients who were scheduled to undergo autologous stem cell transplantation (ASCT) were studied. The patients received three cycles of vincristine-adriamycin-dexamethasone (VAD) regimen as induction chemotherapy, and if they had a partial response, peripheral blood stem cells were collected by dexamethasone-etoposide-cyclophosphamide-cisplatin (DECP). In arm A, six patients received the HDM200. In arm B, three patients received HDM140 + TMI 8 Gy. In arm B, the neutropenic duration was slightly longer than in arm A ( ). However, hematologic recovery (except for neutrophils), transfusion requirement, median duration of hospitalization, and the dose of G-CSF were similar in both arms. The median duration of overall survival and event-free survival was similar in the two arms ( ). As a conditioning regiment, HDM140 + TMI 8 Gy provide another chance for MM Asian patients who were not feasible for HDM200.