Allogeneic hematopoietic cell transplantation for consolidation of VGPR or CR for newly diagnosed multiple myeloma

Nishihori, Taiga; Ochoa-Bayona, José L.; Kim, J; Pidala, Joseph; Shain, Kenneth H.; Baz, Rachid; Sullivan, Daniel M.; Jim, Heather; Anasetti, Claudio; Alsina, Melissa

doi:10.1038/bmt.2013.37

Cited by 16 publications

(12 citation statements)

References 39 publications

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“…×2 days) with (n = 13) or without (n = 9) bortezomib (1.3 mg/m 2 ). The risk of moderate to severe chronic GVHD at 2 years was 46% but the 2-year PFS was 74.8%, comparing favorably with the 52% 2-year PFS seen in similar patients who underwent an autologous HCT [61]. …”

Section: Role Of Allogeneic Hct As Treatment For Patients Relapsing Amentioning

confidence: 99%

American Society of Blood and Marrow Transplantation, European Society of Blood and Marrow Transplantation, Blood and Marrow Transplant Clinical Trials Network, and International Myeloma Working Group Consensus Conference on Salvage Hematopoietic Cell Transplantation in Patients with Relapsed Multiple Myeloma

Giralt

Garderet

Durie

et al. 2015

Biology of Blood and Marrow Transplantation

152

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In contrast to the upfront setting in which the role of high-dose therapy with autologous hematopoietic cell transplantation (HCT) as consolidation of a first remission in patients with multiple myeloma (MM) is well established, the role of high-dose therapy with autologous or allogeneic HCT has not been extensively studied in MM patients relapsing after primary therapy. The International Myeloma Working Group together with the Blood and Marrow Transplant Clinical Trials Network, the American Society of Blood and Marrow Transplantation, and the European Society of Blood and Marrow Transplantation convened a meeting of MM experts to: (1) summarize current knowledge regarding the role of autologous or allogeneic HCT in MM patients progressing after primary therapy, (2) propose guidelines for the use of salvage HCT in MM, (3) identify knowledge gaps, (4) propose a research agenda, and (5) develop a collaborative initiative to move the research agenda forward. After reviewing the available data, the expert committee came to the following consensus statement for salvage autologous HCT: (1) In transplantation-eligible patients relapsing after primary therapy that did NOT include an autologous HCT, high-dose therapy with HCT as part of salvage therapy should be considered standard; (2) High-dose therapy and autologous HCT should be considered appropriate therapy for any patients relapsing after primary therapy that includes an autologous HCT with initial remission duration of more than 18 months; (3) High-dose therapy and autologous HCT can be used as a bridging strategy to allogeneic HCT; (4) The role of postsalvage HCT maintenance needs to be explored in the context of well-designed prospective trials that should include new agents, such as monoclonal antibodies, immune-modulating agents, and oral proteasome inhibitors; (5) Autologous HCT consolidation should be explored as a strategy to develop novel conditioning regimens or post-HCT strategies in patients with short (less than 18 months remissions) after primary therapy; and (6) Prospective randomized trials need to be performed to define the role of salvage autologous HCT in patients with MM relapsing after primary therapy comparing it to “best non-HCT” therapy. The expert committee also underscored the importance of collecting enough hematopoietic stem cells to perform 2 transplantations early in the course of the disease. Regarding allogeneic HCT, the expert committee agreed on the following consensus statements: (1) Allogeneic HCT should be considered appropriate therapy for any eligible patient with early relapse (less than 24 months) after primary therapy that included an autologous HCT and/or high-risk features (ie, cytogenetics, extramedullary disease, plasma cell leukemia, or high lactate dehydrogenase); (2) Allogeneic HCT should be performed in the context of a clinical trial if possible; (3) The role of postallogeneic HCT maintenance therapy needs to be explored in the context of well-designed prospective trials; and (4) Prospective randomized trials nee...

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Section: Role Of Allogeneic Hct As Treatment For Patients Relapsing Amentioning

confidence: 99%

American Society of Blood and Marrow Transplantation, European Society of Blood and Marrow Transplantation, Blood and Marrow Transplant Clinical Trials Network, and International Myeloma Working Group Consensus Conference on Salvage Hematopoietic Cell Transplantation in Patients with Relapsed Multiple Myeloma

Giralt

Garderet

Durie

et al. 2015

Biology of Blood and Marrow Transplantation

152

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“…This would suggest that a graft-versus-malignancy effect mediated by allogeneic T cells is capable of overcoming drug resistance and inducing disease responses, even when refractory to previous high-dose chemotherapy. Similarly, high responses and encouraging survival is seen when RIC allo-HCT is offered earlier in the course of the disease [8]. In our series, 22 subjects with chemosensitive disease (CR: 45%; very good partial response: 55%) underwent a RIC regimen of fludarabine plus melphalan (n = 13; 59%) with or without bortezomib (n = 9; 41%), then received granulocyte-colony stimulating factor mobilized peripheral blood stem cells from a HLA-matched-related (n = 9; 41%) or matched-unrelated (n = 13; 59%) donor [8].…”

Section: Evidence Of Immune Control In MMmentioning

confidence: 99%

Immunotherapy Strategies for Multiple Myeloma: The Present and the Future

et al. 2013

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Growing knowledge of the complexities of the immune system have led to a better understanding of how it can be harnessed for the purpose of anticancer therapy. Moreover, recent success with immunotherapies for solid tumors, combined with novel therapeutic strategies against myeloma, heighten excitement at the prospect of improving clinical outcomes for myeloma by improving antitumor immunity. Increased understanding of myeloma tumor-associated antigens, availability of more potent vaccines, expanded immune-modulating therapies, development of agents that block immune-suppressive pathways, increased sophistication of adoptive cell therapy techniques and capitalization upon standard autologous transplant are all important standalone or combination strategies that might ultimately improve prognosis of patients with multiple myeloma.

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“…Some phase II trials evaluating these concepts have been performed. [45,[47][48][49][50][51][52] Further evidence of a synergism between new drugs and donor T cells has recently been shown in a comparative study in newly diagnosed patients, where higher response rates to salvage therapies with new drugs were observed in the allo-SCT patients. This translated into significantly longer OS from relapse after the allo-SCT, compared to a second auto-SCT [ Figure 2].…”

Section: Autologous Stem Cell Transplantation In Elderly Patientsmentioning

confidence: 99%

Stem cell transplantation in multiple myeloma and other plasma cell disorders (report from an EBMT preceptorship meeting)

Bruno

Auner

Gahrton

et al. 2016

Leukemia & Lymphoma

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The definitive version is available at: La versione definitiva è disponibile alla URL: [http://www.tandfonline.com.offcampus.dam.unito.it/doi/full/10.3109/10428194.2015.1131278] Stem cell transplantation in multiple myeloma and other plasma cell disorders (report from an EBMT preceptorship meeting) AbstractThe European Society for Blood and Marrow Transplantation Chronic Malignancies Working Party held a preceptorship meeting in Turin, Italy on 25-26 September 2014, to discuss the role of stem cell transplantation (SCT) in the treatment of multiple myeloma and other plasma cell disorders. Scientists and clinicians working in the field gathered to discuss a variety of topics including the results of recent clinical trials, basic research, the concept of minimal residual disease, and immune modulation. As individual presentations revealed, important advances have occurred in our understanding of the pathophysiology of myeloma and the role that SCT, along with other forms of immunotherapy, plays in treating it. Each presentation stimulated discussion and exchange of ideas among the attendants. We decided to summarize and, importantly, to update the meeting proceedings in this review to share stimulating discussions and ideas on potentially novel treatment strategies among clinicians.

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Allogeneic hematopoietic cell transplantation for consolidation of VGPR or CR for newly diagnosed multiple myeloma

Cited by 16 publications

References 39 publications

Immunotherapy Strategies for Multiple Myeloma: The Present and the Future

Stem cell transplantation in multiple myeloma and other plasma cell disorders (report from an EBMT preceptorship meeting)

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