Salvage Second Hematopoietic Cell Transplantation in Myeloma Journal Article


Authors: Michaelis, L. C.; Saad, A.; Zhong, X.; Le-Rademacher, J.; Freytes, C. O.; Marks, D. I.; Lazarus, H. M.; Bird, J. M.; Holmberg, L.; Kamble, R. T.; Kumar, S.; Lill, M.; Meehan, K. R.; Saber, W.; Schriber, J.; Tay, J.; Vogl, D. T.; Wirk, B.; Savani, B. N.; Gale, R. P.; Vesole, D. H.; Schiller, G. J.; Abidi, M.; Anderson, K. C.; Nishihori, T.; Kalaycio, M. E.; Vose, J. M.; Moreb, J. S.; Drobyski, W.; Munker, R.; Roy, V.; Ghobadi, A.; Holland, H. K.; Nath, R.; To, L. B.; Maiolino, A.; Kassim, A. A.; Giralt, S. A.; Landau, H.; Schouten, H. C.; Maziarz, R. T.; Michael, J.; Kindwall-Keller, T.; Stiff, P. J.; Gibson, J.; Lonial, S.; Krishnan, A.; Dispenzieri, A.; Hari, P.
Article Title: Salvage Second Hematopoietic Cell Transplantation in Myeloma
Abstract: Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing ≥36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing ≥36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM. © 2013 American Society for Blood and Marrow Transplantation.
Keywords: multiple myeloma; relapsed multiple myeloma; second autologous transplantation
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 19
Issue: 5
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2013-05-01
Start Page: 760
End Page: 766
Language: English
PROVIDER: scopus
PUBMED: 23298856
DOI: 10.1016/j.bbmt.2013.01.004
PMCID: PMC3816739
DOI/URL:
Notes: --- - Cited By (since 1996):1 - "Export Date: 1 May 2013" - "CODEN: BBMTF" - ":doi 10.1016/j.bbmt.2013.01.004" - "Source: Scopus"
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  1. Sergio Andres Giralt
    786 Giralt
  2. Heather Jolie Landau
    271 Landau