Factors associated with favorable outcome after allogeneic hematopoietic stem cell transplantation for multiple myeloma

Allogeneic hematopoietic stem cell transplantation (HSCT) induces graft-versus-myeloma effect and can overcome resistance to conventional therapy but is limited by the risk of graft versus host disease and high transplant-related mortality (TRM). Between 1991 and 2006, 33 patients underwent a myeloablative (52%) or reduced-intensity conditioning (48%) allogeneic HSCT 3.2 months to 15 years after the diagnosis of multiple myeloma (MM). Median overall survival after HSCT was 40.6 months. Twelve patients (36%) are alive, including six patients in Complete response (CR), 8.3 to 172.7 months after HSCT. Patients surviving more than 48 months after transplant were more likely to be younger than 50 (100%vs. 44%, P = 0.017), have received a bone marrow graft (84%vs. 33%, P = 0.033) and less likely to have had prior autologous transplant (0%vs. 56%, P = 0.017). Allogeneic HSCT is feasible in selected patients with MM with adverse disease features and can induced prolonged disease control.