Información sobre costos en Segundos: http://ow.ly/8D2r7 Somos Medicenter, una de las clínicas más avanzada en Trasplantes de Células Madre en Latino América. En esta presentación el Dr. Byron Sánchez, muestra estadísticas de éxito del trasplante de células madre en pacientes con Mieloma Múltiple.

2. Mieloma Múltiple Información para pacientes con Mieloma Múltiple Dr. Byron Sánchez/MEDICENTER Septiembre 2010

12. Sources

15. Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2010 CIBMTR Summary Slides SUM10_1.ppt

16. Transplant activity in the U.S. 1980-2009 Transplants '80 '81 '82 '83 '84 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 Autologous Related Donor Unrelated Donor SUM10_4.ppt Slide 4 10,000 8,000 18,000 12,000 6,000 4,000 2,000 0 16,000 14,000

17. Autologous stem cell sources, by recipient age 1999-2008 Transplants, % SUM10_8.ppt Slide 6 Age  20 yrs Age  20 yrs 1999-2003 2004-2008 1999-2003 2004-2008 80 100 60 40 20 0 Bone Marrow (BM) Peripheral Blood (PB) BM + PB

18. Transplant activity worldwide 1980-2009 Transplants SUM10_3.ppt Slide 3 '80 '81 '82 '83 '84 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 20,000 Autologous Allogeneic 25,000 35,000 30,000 15,000 10,000 5,000 0

19. Trends in transplantation, by transplant type and recipient age * 1999-2008 Transplants, % SUM10_9.ppt Slide 7 Allogeneic Transplants Autologous Transplants 1999-2003 2004-2008 1999-2003 2004-2008 * Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma 80 100 60 40 20 0  20 yrs 21-40 yrs 41-50 yrs 51-60 yrs  60 yrs

20. Indications for hematopoietic stem cell transplant in North America 2008 SUM10_11.ppt Slide 9 Number of Transplants Multiple Myeloma NHL AML HD ALL MDS/MPD Aplastic Anemia CML Other Leuk Other Cancer Non- Malig Disease Allogeneic (Total N=6,672) Autologous (Total N=10,302) 3,000 5,500 2,000 1,500 500 0 1,000 2,500 3,500 4,000 4,500 5,000

23. EL TRASPLANTE AUTOLOGO SE RECOMIENDA PARA PACIENTES CON MIELOMA ACTIVO, QUE SEAN RELATIVAMENTE JOVENES Y QUE NO TIENEN ENFERMEDADES COEXISTENTES SERIAS………..

24. MIELOMA MULTIPLE IFM 90 TX AUTO QUIMIO RR 81% 57% CR 22% 5% EFS 7a. 16% 8% OS 57% 44%

25. 100-day mortality after autologous transplantation 2007-2008 SUM10_19.ppt Slide 17 Mortality, % 12 15 9 6 3 0 Acute Leukemia Non-Hodgkin Lymphoma Hodgkin Disease Multiple Myeloma Early Disease Intermediate/Advance Disease Sensitive Resistant Other

26. Causes of death after transplantations done in 2003-2008 SUM10_22.ppt Slide 20 Infection (17%) Other Cause (19%) Organ Failure (12%) Primary Disease (35%) IPn * (5%) GVHD (12%) Infection (14%) Other (22%) GVHD (10%) Primary Disease (43%) IPn * (3%) Organ Failure (8%) Infection (5%) Other Cause (17%) Organ Failure (4%) IPn * (1%) Primary Disease (73%) *IPn = Idiopathic pneumonia syndrome Autologous Unrelated donor HLA-identical sibling

27. Probability of survival after transplant for multiple myeloma, by donor type 1998-2008 Years 0 2 6 1 3 4 5 Probability of Survival, % HLA-matched sibling, Allo (N=878) autologous transplant (N=22,254) Unrelated, Allo (N=143) P < 0.0001 SUM10_56.ppt Slide 49 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90

30. Recomendable!

31. PASO I Terapia de Inducción 4-6meses

32. Paso II Documentar Respuesta

33. Paso III Movilización de Stem Cells

34. Paso IV Recolección por Aféresis

35. Paso V Separación y Criopreservación

36. Paso VI Hospitalización y Quimioterapia de acondicionamiento 48 horas

37. Paso VII Reinfusión de Stem Cells 48 horas posterior a Quimio

42. http://trasplantecelulasmadre.wordpress.com [email_address]