Ann Transpl
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Randomized Controlled Trial Multicenter Study Clinical Trial
Freedom from rejection and stable kidney function are excellent criteria for steroid withdrawal in tacrolimus-treated kidney transplant recipients.
This prospective, randomized, multicentre study investigated the efficacy and safety of two tacrolimus-based regimens and their potential to withdraw steroids. ⋯ Both tacrolimus regimens are efficacious and safe. The combination of Tacrolimus and MMF achieved a lower rejection rate and permitted a higher proportion of steroid-free patients. The overall incidence of acute rejection was low and kidney function was good.
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The treatment of multiple myeloma still remains under investigation. Conventional chemotherapy with currently used agents (i.e., Melphalan) effects complete remission in no more than 5% of patients. High dose chemotherapy followed by hematopoietic stem cells transplantation results in complete remission rates between 25% and 75% and a 3-year probability of event-free survival between 40% and 60% but is not curative since most patients relapse after 1.5 to 3 years. ⋯ Several regimens have been proposed for stem cells mobilization including: High-dose cyclophosphamide and G or GM-CSF, G-CSF alone, and cyclophosphamide and etoposide with G-CSF... ect.. Further attempts to improve the results of autotransplantation have included intensification with tandem transplantations (double transplants) and reduction of tumor cells in stem cell infusion. The aim of this review is to summarize the current knowledge about the treatment of multiple myeloma with high dose chemotherapy with autologous hematopoietic stem cell transplantation.