Predictors of prolonged survival after allogeneic hematopoietic stem cell transplantation for multiple myeloma Journal Article
| Authors: | Bashir, Q.; Khan, H.; Orlowski, R. Z.; Amjad, A. I.; Shah, N.; Parmar, S.; Wei, W.; Rondon, G.; Weber, D. M.; Wang, M.; Thomas, S. K.; Shah, J. J.; Qureshi, S. R.; Dinh, Y. T.; Popat, U.; Anderlini, P.; Hosing, C.; Giralt, S.; Champlin, R. E.; Qazilbash, M. H. |
| Article Title: | Predictors of prolonged survival after allogeneic hematopoietic stem cell transplantation for multiple myeloma |
| Abstract: | A total of 149 patients with multiple myeloma (MM) who received allogeneic hematopoietic stem cell transplantation (allo-HCT) with myeloablative (MAC; n = 38) or reduced-intensity conditioning (RIC; n = 110) regimens at MD Anderson Cancer Center were evaluated. Of the total, 120 (81%) patients had relapsed or had refractory disease. Median age of MM patients was 50 (28-70) years with a followup time of 28.5 (3-164) months. The 100-day and 5-year treatment related mortality (TRM) rates were 17% and 47%, respectively. TRM was significantly lower with RIC regimens (13%) vs. 29% for MAC at 100 days (P = 0.012). The cumulative incidence of Grade II-IV acute graft-versus-host disease (GVHD) was 35% and chronic GVHD was 46%. PFS and OS at 5 years were 15% and 21%, respectively. In multivariate analysis, allo-HCT for primary remission consolidation was associated with longer PFS (HR 0.35; 95% CI, 0.18-0.67) and OS (HR 0.29; 95% CI 0.15-0.55), while absence of high-risk cytogenetics was associated with longer PFS only (HR 0.59; 95% CI 0.37-0.95). We observe that TRM has decreased with the use of RIC regimens, and long-term disease control can be expected in a subset of MM patients undergoing allo-HCT. Further studies should be conducted in carefully designed clinical trials in this patient population. © 2011 Wiley Periodicals, Inc. |
| Keywords: | adult; cancer survival; aged; middle aged; survival rate; retrospective studies; transplantation, homologous; major clinical study; overall survival; busulfan; fludarabine; salvage therapy; methotrexate; rituximab; follow up; follow-up studies; progression free survival; multiple myeloma; antineoplastic combined chemotherapy protocols; incidence; cytogenetics; cyclophosphamide; melphalan; hematopoietic stem cell transplantation; thiotepa; acute graft versus host disease; chronic graft versus host disease; whole body radiation; graft versus host reaction; reduced intensity conditioning; transplantation conditioning; allogeneic hematopoietic stem cell transplantation; cancer relapse; graft survival; tacrolimus; graft vs host disease; mycophenolic acid 2 morpholinoethyl ester; cyclosporin; immunosuppressive agents; alemtuzumab; thymocyte antibody; kaplan-meier estimate; myeloablative agonists; consolidation chemotherapy; primary graft dysfunction |
| Journal Title: | American Journal of Hematology |
| Volume: | 87 |
| Issue: | 3 |
| ISSN: | 0361-8609 |
| Publisher: | John Wiley & Sons, Inc. |
| Date Published: | 2012-03-01 |
| Start Page: | 272 |
| End Page: | 276 |
| Language: | English |
| DOI: | 10.1002/ajh.22273 |
| PROVIDER: | scopus |
| PUBMED: | 22231283 |
| PMCID: | PMC3894831 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 2 April 2012" - "CODEN: AJHED" - "Source: Scopus" |
