Outcome of unrelated transplants in patients with multiple myeloma

Ballen, Karen K.; King, Roberta; Carston, Michael J.; Kollman, Craig; Nelson, Gene; Lim, Seah H.; Reece, Donna; Giralt, Sergío

doi:10.1038/sj.bmt.1704868

Cited by 28 publications

(14 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Myeloablative allogeneic HCT has been shown to be an effective treatment for MM, but high transplantrelated mortality (TRM) remains a concern [2][3][4]. A graft-versus-myeloma effect has been demonstrated [5,6], but poor results have been reported for allogeneic HCT using unrelated donors [7]. Allogeneic HCT with reduced intensity conditioning (RIC) regimens may be preferable in the treatment of older and heavily pretreated patients due to an observed lower TRM compared with myeloablative HCT, but has a higher risk of relapse and disease progression [8].…”

Section: Introductionmentioning

confidence: 99%

Allogeneic hematopoietic cell transplant for multiple myeloma using reduced intensity conditioning therapy, 1998–2006: factors associated with improved survival outcome

Nivison-Smith

Dodds

Doocey

et al. 2011

Leukemia & Lymphoma

View full text Add to dashboard Cite

This study reports on the outcome of 95 allogeneic hematopoietic cell transplants (HCTs) using reduced intensity conditioning (RIC) performed for patients with multiple myeloma (MM) in Australia and New Zealand between 1998 and 2006. The median age at HCT was 52 years. Of the 32 patients for whom the allograft was performed as a first transplant, 15 (47%) had their allograft less than 1 year from diagnosis, while for the 63 patients who had an allograft following an autograft, nine (14%) were allografted within 1 year post-diagnosis (p < 0.001). The cumulative incidence of transplant-related mortality (TRM) was 19% at 1 year post-transplant. At 5 years post-transplant the overall survival (OS) was 40% and progression-free survival (PFS) was 23%, with no apparent survival plateau. Three factors were independently favorable predictors of OS in a Cox regression model: immunoglobulin G (IgG) myeloma (hazard ratio [HR] = 0.42, 95% confidence interval [CI] 0.24-0.75, p = 0.004), a human leukocyte antigen (HLA)-identical sibling donor (HR = 0.37, 95% CI 0.18-0.74, p = 0.005), and less than 1 year between MM diagnosis and RIC HCT (HR = 0.27, 95% CI 0.12-0.59, p = 0.001). Patterns of outcome indicate that RIC HCT may offer the potential for cure for only a small group of patients with MM.

show abstract

Section: Introductionmentioning

confidence: 99%

Allogeneic hematopoietic cell transplant for multiple myeloma using reduced intensity conditioning therapy, 1998–2006: factors associated with improved survival outcome

Nivison-Smith

Dodds

Doocey

et al. 2011

Leukemia & Lymphoma

View full text Add to dashboard Cite

show abstract

“…Ballen et al [29] reviewed unrelated donor myeloablative allo-SCT in 70 patients with myeloma whose transplantations were facilitated by the National Marrow Donor Program between 1989 and 2000. Most of the patients (64%) received a TBI-based conditioning regimen, and 39% received a T-cell-depleted graft.…”

Section: Conventional Allo-sct In Myelomamentioning

confidence: 99%

Role of allogeneic stem cell transplantation in multiple myeloma

Kumar

2008

Curr Hematol Malig Rep

View full text Add to dashboard Cite

Multiple myeloma remains incurable despite the use of high-dose therapy and autologous stem cell transplantation and the introduction of novel agents with high response rates. The use of an uncontaminated stem cell graft and the presence of a graft-versus-myeloma effect led to the use of allogeneic stem cell transplantation in myeloma, and it has been part of the therapeutic armamentarium for more than a decade. Early results were discouraging due to high transplantation-related mortality and high rates of graft-versus-host disease. More recently, better supportive care, increasing experience with this modality and its complications, use of reduced-intensity conditioning regimens, and its use earlier in the course of disease have led to improved outcomes. Patients with high-risk genetic and biochemical features do poorly with conventional therapies, and allogeneic transplantation offers the potential for long-term disease control.

show abstract

“…The 5-year PFS and OS was only 7 and 9%, respectively, due to a high day-100 mortality of 42% and a cumulative incidence of relapse of 34% at 3 years. The major causes of death were infectious complications (50%), toxicity (19%), and graft-versus-host disease (GvHD) (16%) [24]. The Seattle group reported on 14 patients who received allogeneic SCT from unrelated or mismatched related donors after myeloablative conditioning.…”

Section: Unrelated Stem Cell Transplantation After Myeloablative Condmentioning

confidence: 99%

“…Ballen et al [24] analyzed 71 patients who received a myeloablative conditioning regimen followed by allogeneic SCT from an unrelated donor facilitated by the National Marrow Donor Program (NMDP). The median age was 44 years, and 31% had received preceding autologous SCT.…”

Section: Unrelated Stem Cell Transplantation After Myeloablative Condmentioning

confidence: 99%