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

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    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
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    Affiliation
    Clinical Haematology, Box 234, Addenbrookes Hospital, Cambridge, CB2 2QQ, United Kingdom. charles.crawley@addenbrookes.nhs.uk
    Issue Date
    2005-06-01
    
    Metadata
    Show full item record
    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.
    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
    URI
    http://hdl.handle.net/10541/75811
    DOI
    10.1182/blood-2004-06-2387
    PubMed ID
    15731182
    Language
    en
    ISSN
    0006-4971
    ae974a485f413a2113503eed53cd6c53
    10.1182/blood-2004-06-2387
    Scopus Count
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