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, CharlesLalancette, 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
Affiliation
Clinical Haematology, Box 234, Addenbrookes Hospital, Cambridge, CB2 2QQ, United Kingdom. charles.crawley@addenbrookes.nhs.ukIssue Date
2005-06-01
Metadata
Show full item recordAbstract
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.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 BloodJournal
BloodDOI
10.1182/blood-2004-06-2387PubMed ID
15731182Language
enISSN
0006-4971ae974a485f413a2113503eed53cd6c53
10.1182/blood-2004-06-2387