Comparison of Twin and Autologous Transplants for Multiple Myeloma

Asad Bashey, Waleska S. Pérez, Mei Jie Zhang, Kenneth C. Anderson, Karen Ballen, James R. Berenson, L. Bik To, Rafael Fonseca, César O. Freytes, Robert Peter Gale, John Gibson, Sergio A. Giralt, Robert A. Kyle, Hillard M. Lazarus, Dipnarine Maharaj, Philip L. McCarthy, Gustavo A. Milone, Stephen Nimer, Santiago Pavlovsky, Donna E. ReeceGary Schiller, David H. Vesole, Parameswaran Hari

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Relapse is the overwhelming cause of treatment failure after autologous transplantation for multiple myeloma (MM). For patients with a syngeneic donor, twin transplants provide a healthy graft that is free of myeloma. The relative impact of the graft on posttransplant relapse can be estimated by comparing risk of relapse after hematopoietic cell transplantation from genetically identical twins versus autotransplants because confounding differences in minor or major histocompatibility antigens are absent in the syngeneic transplant setting. Outcomes of 43 subjects who received twin transplants for MM were compared to 170 matched autotransplant recipients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Multivariate analysis was performed by fitting a Cox model stratified on matched pairs. The matched transplant patients studied were similar with respect to subject-, disease-, and transplant-related characteristics. Cumulative incidence of relapse/progression was significantly lower, and progression-free survival (PFS) was significantly higher following twin transplants. In multivariate analysis, the probability of relapse/progression was lower in twins (relative risk [RR] = 0.49, 95% confidence interval [CI] 0.28-0.86, P = .011). Twin transplants have a significantly lower relapse risk than autotransplants in MM, suggesting that graft composition may impact outcomes following high-dose chemotherapy.

Original languageEnglish (US)
Pages (from-to)1118-1124
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume14
Issue number10
DOIs
StatePublished - Oct 2008

Fingerprint

Autografts
Multiple Myeloma
Transplants
Recurrence
Multivariate Analysis
Histocompatibility Antigens
Monozygotic Twins
Autologous Transplantation
Cell Transplantation
Treatment Failure
Proportional Hazards Models
Disease-Free Survival
Bone Marrow
Tissue Donors
Confidence Intervals
Drug Therapy

Keywords

  • Autotransplant
  • Graft-versus-myeloma
  • Multiple myeloma
  • Twin

ASJC Scopus subject areas

  • Transplantation

Cite this

Bashey, A., Pérez, W. S., Zhang, M. J., Anderson, K. C., Ballen, K., Berenson, J. R., ... Hari, P. (2008). Comparison of Twin and Autologous Transplants for Multiple Myeloma. Biology of Blood and Marrow Transplantation, 14(10), 1118-1124. https://doi.org/10.1016/j.bbmt.2008.07.007

Comparison of Twin and Autologous Transplants for Multiple Myeloma. / Bashey, Asad; Pérez, Waleska S.; Zhang, Mei Jie; Anderson, Kenneth C.; Ballen, Karen; Berenson, James R.; To, L. Bik; Fonseca, Rafael; Freytes, César O.; Gale, Robert Peter; Gibson, John; Giralt, Sergio A.; Kyle, Robert A.; Lazarus, Hillard M.; Maharaj, Dipnarine; McCarthy, Philip L.; Milone, Gustavo A.; Nimer, Stephen; Pavlovsky, Santiago; Reece, Donna E.; Schiller, Gary; Vesole, David H.; Hari, Parameswaran.

In: Biology of Blood and Marrow Transplantation, Vol. 14, No. 10, 10.2008, p. 1118-1124.

Research output: Contribution to journalArticle

Bashey, A, Pérez, WS, Zhang, MJ, Anderson, KC, Ballen, K, Berenson, JR, To, LB, Fonseca, R, Freytes, CO, Gale, RP, Gibson, J, Giralt, SA, Kyle, RA, Lazarus, HM, Maharaj, D, McCarthy, PL, Milone, GA, Nimer, S, Pavlovsky, S, Reece, DE, Schiller, G, Vesole, DH & Hari, P 2008, 'Comparison of Twin and Autologous Transplants for Multiple Myeloma', Biology of Blood and Marrow Transplantation, vol. 14, no. 10, pp. 1118-1124. https://doi.org/10.1016/j.bbmt.2008.07.007
Bashey A, Pérez WS, Zhang MJ, Anderson KC, Ballen K, Berenson JR et al. Comparison of Twin and Autologous Transplants for Multiple Myeloma. Biology of Blood and Marrow Transplantation. 2008 Oct;14(10):1118-1124. https://doi.org/10.1016/j.bbmt.2008.07.007
Bashey, Asad ; Pérez, Waleska S. ; Zhang, Mei Jie ; Anderson, Kenneth C. ; Ballen, Karen ; Berenson, James R. ; To, L. Bik ; Fonseca, Rafael ; Freytes, César O. ; Gale, Robert Peter ; Gibson, John ; Giralt, Sergio A. ; Kyle, Robert A. ; Lazarus, Hillard M. ; Maharaj, Dipnarine ; McCarthy, Philip L. ; Milone, Gustavo A. ; Nimer, Stephen ; Pavlovsky, Santiago ; Reece, Donna E. ; Schiller, Gary ; Vesole, David H. ; Hari, Parameswaran. / Comparison of Twin and Autologous Transplants for Multiple Myeloma. In: Biology of Blood and Marrow Transplantation. 2008 ; Vol. 14, No. 10. pp. 1118-1124.
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