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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.
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
html.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.


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