Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT.

2.50
Hdl Handle:
http://hdl.handle.net/10541/75811
Title:
Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT.
Authors:
Crawley, Charles; Lalancette, Marc; Szydlo, Richard; Gilleece, Maria H; Peggs, Karl S; Mackinnon, Stephen; Juliusson, Gunnar; Ahlberg, Lucia; Nagler, Arnon; Shimoni, Avichai; Sureda, Anna; Boiron, Jean-Michel; Einsele, Herman; Chopra, Rajesh; Carella, Angelo; Cavenagh, Jamie; Gratwohl, Alois; Garban, Frederic; Zander, Axel; Björkstrand, Bo; Niederwieser, Dietger; Gahrton, Gösta; Apperley, Jane F
Abstract:
We report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21%, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (RR, 1.45). Adverse PFS was associated with chemoresistance (RR, 2.4) and alemtuzumab (RR, 1.8). TRM was increased with female-to-male donation (RR, 2.5) and transplantation more than 1 year from diagnosis (RR, 2.3). Grades II to IV acute graft-versus-host disease (aGvHD) occurred in 31%. Chronic GvHD was associated with better OS and PFS and were 84% and 46% for limited, 58% and 30% for extensive, and 29% and 12% in its absence suggesting that a graft-versus-myeloma effect is important. While RIC is feasible, heavily pretreated patients and patients with progressive disease do not benefit.
Affiliation:
Clinical Haematology, Box 234, Addenbrookes Hospital, Cambridge, CB2 2QQ, United Kingdom. charles.crawley@addenbrookes.nhs.uk
Citation:
Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT. 2005, 105 (11):4532-9 Blood
Journal:
Blood
Issue Date:
1-Jun-2005
URI:
http://hdl.handle.net/10541/75811
DOI:
10.1182/blood-2004-06-2387
PubMed ID:
15731182
Language:
en
ISSN:
0006-4971
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorCrawley, Charles-
dc.contributor.authorLalancette, Marc-
dc.contributor.authorSzydlo, Richard-
dc.contributor.authorGilleece, Maria H-
dc.contributor.authorPeggs, Karl S-
dc.contributor.authorMackinnon, Stephen-
dc.contributor.authorJuliusson, Gunnar-
dc.contributor.authorAhlberg, Lucia-
dc.contributor.authorNagler, Arnon-
dc.contributor.authorShimoni, Avichai-
dc.contributor.authorSureda, Anna-
dc.contributor.authorBoiron, Jean-Michel-
dc.contributor.authorEinsele, Herman-
dc.contributor.authorChopra, Rajesh-
dc.contributor.authorCarella, Angelo-
dc.contributor.authorCavenagh, Jamie-
dc.contributor.authorGratwohl, Alois-
dc.contributor.authorGarban, Frederic-
dc.contributor.authorZander, Axel-
dc.contributor.authorBjörkstrand, Bo-
dc.contributor.authorNiederwieser, Dietger-
dc.contributor.authorGahrton, Gösta-
dc.contributor.authorApperley, Jane F-
dc.date.accessioned2009-07-29T12:02:20Z-
dc.date.available2009-07-29T12:02:20Z-
dc.date.issued2005-06-01-
dc.identifier.citationOutcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT. 2005, 105 (11):4532-9 Blooden
dc.identifier.issn0006-4971-
dc.identifier.pmid15731182-
dc.identifier.doi10.1182/blood-2004-06-2387-
dc.identifier.urihttp://hdl.handle.net/10541/75811-
dc.description.abstractWe report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21%, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (RR, 1.45). Adverse PFS was associated with chemoresistance (RR, 2.4) and alemtuzumab (RR, 1.8). TRM was increased with female-to-male donation (RR, 2.5) and transplantation more than 1 year from diagnosis (RR, 2.3). Grades II to IV acute graft-versus-host disease (aGvHD) occurred in 31%. Chronic GvHD was associated with better OS and PFS and were 84% and 46% for limited, 58% and 30% for extensive, and 29% and 12% in its absence suggesting that a graft-versus-myeloma effect is important. While RIC is feasible, heavily pretreated patients and patients with progressive disease do not benefit.en
dc.language.isoenen
dc.subjectHaematopoietic Stem Cell Transplantationen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshFemale-
dc.subject.meshGraft vs Host Disease-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHumans-
dc.subject.meshLymphocyte Depletion-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshMultiple Myeloma-
dc.subject.meshRisk Factors-
dc.subject.meshSurvival Analysis-
dc.subject.meshTransplantation Conditioning-
dc.subject.meshTransplantation, Homologous-
dc.subject.meshTreatment Outcome-
dc.subject.meshVidarabine-
dc.titleOutcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT.en
dc.contributor.departmentClinical Haematology, Box 234, Addenbrookes Hospital, Cambridge, CB2 2QQ, United Kingdom. charles.crawley@addenbrookes.nhs.uken
dc.identifier.journalBlooden

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