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MM-609 Concomitant Effect of Autologous Stem Cell Transplantation on Extensive Psoriasis in Treating a Patient With Multiple Myeloma in Complete Response

Autologous stem cell transplantation is a cornerstone in treating patients with multiple myeloma in need for long term remissions. It can also show marked improvement of accompanying systemic immune diseases. The case may highlight the role of ASCT in treatment of some systemic immune diseases which...

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Published in:Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2023-09, Vol.23, p.S510-S510
Main Authors: Talaat, Ahmed, Atef, Basma, El-Bayoumi, Noreen M.A., El-Sheltawy, Nada F., Badawy, Noha M., Abbas, Arwa, Mohsen, Asmaa, Fathi, Dina, Elbogdady, Mohamed, Elsergany, Alyaa R., Denewer, May, El ashwah, Shaimaa, Taalab, Mona, Elbayomy, M., Abd Elhamid, M., Ghazy, Hayam, Awad, M., Elkhodary, T., Ibrahim, Maha, Azmy, Emad, Mabed, Mohamed, Shamaa, Sameh
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Language:English
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Summary:Autologous stem cell transplantation is a cornerstone in treating patients with multiple myeloma in need for long term remissions. It can also show marked improvement of accompanying systemic immune diseases. The case may highlight the role of ASCT in treatment of some systemic immune diseases which are refractory to usual treatment regimens. Male patient who was already on local treatment of psoriasis and recently diagnosed as a case of multiple myeloma. Bone marrow transplantation unit, Oncology Centre, Mansoura University. The patient was referred to BMT unit for ASCT after achieving complete response of multiple myeloma. The patient received VCD protocol for 6 cycles then achieved complete response and was subjected to ASCT aiming for long term remission. The patient was delayed for ASCT as he received HCV treatment for 3 months before transplantation. He received high dose melphalan as a conditioning regimen while the lesions of psoriasis were observed during the transplantation process and during the subsequent follow-up dates. The patient experienced mild improvement of psoriatic lesions on Day +3 post-transplant then CBC recovered by Day +13 and the patient was fit for discharge. Blood picture, renal functions and PEP in follow-up dates till Day +78 were normal and the general condition of the patient was improving. The lesions of psoriasis showed nearly total resolution by Day +33 and they are still in remission till Day +100. Clinical data show that ASCT can be effective against severe autoimmune diseases such as psoriasis. The mechanisms by which ASCT have therapeutic value in AIDs are unclear. The depletion of pre-existing auto-reactive lymphocytes by the conditioning therapy before ASCT might be an important mechanism of disease regression, ASCT can then be associated with the generation of a new T-cell pool that may be tolerant to selfantigens.
ISSN:2152-2650
2152-2669
DOI:10.1016/S2152-2650(23)01473-8