Analysis of outcome following allogeneic haemopoietic stem cell transplantation for myeloma using myeloablative conditioning--evidence for a superior outcome using melphalan combined with total body irradiation.

2.50
Hdl Handle:
http://hdl.handle.net/10541/74925
Title:
Analysis of outcome following allogeneic haemopoietic stem cell transplantation for myeloma using myeloablative conditioning--evidence for a superior outcome using melphalan combined with total body irradiation.
Authors:
Hunter, H M; Peggs, Karl S; Powles, R; Rahemtulla, A; Mahendra, Premini; Cavenagh, Jamie; Littlewood, Timothy; Potter, M; Hunter, Ann; Pagliuca, A; Williams, Catherine D; Cook, Gordon; Towlson, Keiren; Marks, David I; Russell, Nigel
Abstract:
We have undertaken a retrospective multicentre analysis of 139 patients (median age 44.4 years) undergoing allogeneic haematopoietic stem cell transplantation (HSCT) for multiple myeloma using myeloablative conditioning. The majority of patients received total body irradiation (TBI) combined with either melphalan (56.9%) or cyclophosphamide (28.5%). Overall, transplant-related mortality (TRM) was 37.9% at 1 year and was not significantly different for patients receiving melphalan/TBI compared with cyclophosphamide/TBI. The overall complete remission (CR) rate, including patients in CR at the time of transplant, was greater for patients receiving melphalan/TBI (64.7%) compared with cyclophosphamide/TBI (47.2%)(P = 0.085). A significantly higher proportion of patients with continuing disease at the time of transplant achieved CR post-transplant following melphalan/TBI conditioning compared with cyclophosphamide/TBI (52.9% and 33.4% respectively, P = 0.009). Relapse/progression rates at 5 years were significantly lower for melphalan/TBI (36.7%) compared with cyclophosphamide/TBI (80.8%, P < 0.0001) and remained significant in multivariate analysis. This resulted in an overall survival at 5 years of 44.1% and 28.1% for melphalan/TBI and cyclophosphamide/TBI, respectively (P = 0.059). These results demonstrate that the type of conditioning for sibling allogeneic HSCT for myeloma has a major effect on transplant outcome.
Affiliation:
Nottingham City Hospital, Nottingham NG5 1PB, UK.
Citation:
Analysis of outcome following allogeneic haemopoietic stem cell transplantation for myeloma using myeloablative conditioning--evidence for a superior outcome using melphalan combined with total body irradiation. 2005, 128 (4):496-502 Br. J. Haematol.
Journal:
British Journal of Haematology
Issue Date:
Feb-2005
URI:
http://hdl.handle.net/10541/74925
DOI:
10.1111/j.1365-2141.2004.05330.x
PubMed ID:
15686458
Type:
Article
Language:
en
ISSN:
0007-1048
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorHunter, H M-
dc.contributor.authorPeggs, Karl S-
dc.contributor.authorPowles, R-
dc.contributor.authorRahemtulla, A-
dc.contributor.authorMahendra, Premini-
dc.contributor.authorCavenagh, Jamie-
dc.contributor.authorLittlewood, Timothy-
dc.contributor.authorPotter, M-
dc.contributor.authorHunter, Ann-
dc.contributor.authorPagliuca, A-
dc.contributor.authorWilliams, Catherine D-
dc.contributor.authorCook, Gordon-
dc.contributor.authorTowlson, Keiren-
dc.contributor.authorMarks, David I-
dc.contributor.authorRussell, Nigel-
dc.date.accessioned2009-07-22T10:36:02Z-
dc.date.available2009-07-22T10:36:02Z-
dc.date.issued2005-02-
dc.identifier.citationAnalysis of outcome following allogeneic haemopoietic stem cell transplantation for myeloma using myeloablative conditioning--evidence for a superior outcome using melphalan combined with total body irradiation. 2005, 128 (4):496-502 Br. J. Haematol.en
dc.identifier.issn0007-1048-
dc.identifier.pmid15686458-
dc.identifier.doi10.1111/j.1365-2141.2004.05330.x-
dc.identifier.urihttp://hdl.handle.net/10541/74925-
dc.description.abstractWe have undertaken a retrospective multicentre analysis of 139 patients (median age 44.4 years) undergoing allogeneic haematopoietic stem cell transplantation (HSCT) for multiple myeloma using myeloablative conditioning. The majority of patients received total body irradiation (TBI) combined with either melphalan (56.9%) or cyclophosphamide (28.5%). Overall, transplant-related mortality (TRM) was 37.9% at 1 year and was not significantly different for patients receiving melphalan/TBI compared with cyclophosphamide/TBI. The overall complete remission (CR) rate, including patients in CR at the time of transplant, was greater for patients receiving melphalan/TBI (64.7%) compared with cyclophosphamide/TBI (47.2%)(P = 0.085). A significantly higher proportion of patients with continuing disease at the time of transplant achieved CR post-transplant following melphalan/TBI conditioning compared with cyclophosphamide/TBI (52.9% and 33.4% respectively, P = 0.009). Relapse/progression rates at 5 years were significantly lower for melphalan/TBI (36.7%) compared with cyclophosphamide/TBI (80.8%, P < 0.0001) and remained significant in multivariate analysis. This resulted in an overall survival at 5 years of 44.1% and 28.1% for melphalan/TBI and cyclophosphamide/TBI, respectively (P = 0.059). These results demonstrate that the type of conditioning for sibling allogeneic HSCT for myeloma has a major effect on transplant outcome.en
dc.language.isoenen
dc.subjectHaematopoietic Stem Cell Transplantationen
dc.subject.meshAdult-
dc.subject.meshAntineoplastic Agents, Alkylating-
dc.subject.meshDisease Progression-
dc.subject.meshDisease-Free Survival-
dc.subject.meshFemale-
dc.subject.meshGraft vs Host Disease-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMelphalan-
dc.subject.meshMiddle Aged-
dc.subject.meshMultiple Myeloma-
dc.subject.meshRemission Induction-
dc.subject.meshRetrospective Studies-
dc.subject.meshSurvival Analysis-
dc.subject.meshTransplantation Conditioning-
dc.subject.meshTreatment Outcome-
dc.subject.meshWhole-Body Irradiation-
dc.titleAnalysis of outcome following allogeneic haemopoietic stem cell transplantation for myeloma using myeloablative conditioning--evidence for a superior outcome using melphalan combined with total body irradiation.en
dc.typeArticleen
dc.contributor.departmentNottingham City Hospital, Nottingham NG5 1PB, UK.en
dc.identifier.journalBritish Journal of Haematologyen

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