Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party
AuthorsHayden, P. J.
Eikema, D. J.
de Wreede, L. C.
Veelken, J. H.
Carella, A. M.
AffiliationDepartment of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland.
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AbstractThe EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30-46%) at 2 years and 25% (17-32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24-46%); Others 9% (0-17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33-67%); Other 22% (8-36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21-40%) vs. 10% (1-20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24-0.67), p < 0.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.
CitationHayden PJ, Eikema D-J, de Wreede LC, Koster L, Kröger N, Einsele H, et al. Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party. Bone Marrow Transplant. 2021 May 11.
JournalBone Marrow Transplantation