Abstracts of Clinical Meeting on 12-July-2002
UKMF Pilot Study: The Mini-allograft Trial
Dr Cathy Williams, Senior Lecturer and Honorary Consultant Haematologist, Christie Hospital, Manchester
This trial received MREC approval in April 2001 and several centres had LREC approval by late 2001. The trial is therefore still in its early stages. To date, 7 patients have been entered into the trial from 4 centres. Of these 7, all have completed their autograft successfully and 3 have gone onto to receive a mini-allograft.
The mean time between autograft and mini-allograft is 4.5 months. The mean time until neutrophil recovery in these patients following the mini-allograft was day +12.
There were no complications during the transplants, although one patient developed a gram negetive sepsis which responded to antibiotic therapy. Only one patient has developed GVHD and this is Grade 1 skin.
Of the other 4 patients, one withdrew consent for the mini-allograft and did not proceed, whilst the other three are all due to go ahead within the next month.
The dose of Campath originally recommended in the mini-allograft protocol (100mg) was empirical. There is now recognition that whilst it helps prevent GVHD it may not be optimal with regard to infective complications following the transplant or allow the best disease response. A de-escalation study looking at lower doses (cohorts of 60mg, 40mg, 30mg and 20mg) is now underway in the UK and an application has been submitted to MREC to allow this amendment in the Myeloma Mini-allograft Trial.