@article{4d87d62203c143a7b1c1a2b6fd703622,
title = "Salvage Second Hematopoietic Cell Transplantation in Myeloma",
abstract = "Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing ≥36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing ≥36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.",
keywords = "Multiple myeloma, Relapsed multiple myeloma, Second autologous transplantation",
author = "Michaelis, {Laura C.} and Ayman Saad and Xiaobo Zhong and Jennifer Le-Rademacher and Freytes, {Cesar O.} and Marks, {David I.} and Lazarus, {Hillard M.} and Bird, {Jennifer M.} and Leona Holmberg and Kamble, {Rammurti T.} and Shaji Kumar and Michael Lill and Meehan, {Kenneth R.} and Wael Saber and Jeffrey Schriber and Jason Tay and Vogl, {Dan T.} and Baldeep Wirk and Savani, {Bipin N.} and Gale, {Robert P.} and Vesole, {David H.} and Schiller, {Gary J.} and Muneer Abidi and Anderson, {Kenneth C.} and Taiga Nishihori and Kalaycio, {Matt E.} and Vose, {Julie M.} and Moreb, {Jan S.} and William Drobyski and Reinhold Munker and Vivek Roy and Armin Ghobadi and Holland, {H. Kent} and Rajneesh Nath and To, {L. Bik} and Angelo Maiolino and Kassim, {Adetola A.} and Giralt, {Sergio A.} and Heather Landau and Schouten, {Harry C.} and Maziarz, {Richard T.} and Joseph Michael and Tamila Kindwall-Keller and Stiff, {Patrick J.} and John Gibson and Sagar Lonial and Amrita Krishnan and Angela Dispenzieri and Parameswaran Hari",
note = "Funding Information: Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI) , the National Heart, Lung and Blood Institute (NHLBI) , and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI ; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS) ; two grants, N00014-06-1-0704 and N00014-08-1-0058 , from the Office of Naval Research ; and grants from Allos, Inc. ; Amgen, Inc. ; Angioblast; Anonymous donation to the Medical College of Wisconsin ; Ariad ; Be the Match Foundation ; Blue Cross and Blue Shield Association ; Buchanan Family Foundation ; CaridianBCT ; Celgene Corporation ; CellGenix, GmbH ; Children's Leukemia Research Association ; Fresenius-Biotech North America, Inc. ; Gamida Cell Teva Joint Venture Ltd. ; Genentech, Inc. ; Genzyme Corporation ; GlaxoSmithKline ; HistoGenetics, Inc. ; Kiadis Pharma ; The Leukemia & Lymphoma Society ; The Medical College of Wisconsin ; Merck & Co, Inc. ; Millennium: The Takeda Oncology Co. ; Milliman USA, Inc. ; Miltenyi Biotec, Inc. ; National Marrow Donor Program ; Optum Healthcare Solutions, Inc. ; Osiris Therapeutics, Inc. ; Otsuka America Pharmaceutical, Inc. ; RemedyMD ; Sanofi ; Seattle Genetics ; Sigma-Tau Pharmaceuticals ; Soligenix, Inc. ; StemCyte, A Global Cord Blood Therapeutics Co. ; Stemsoft Software, Inc. ; Swedish Orphan Biovitrum ; Tarix Pharmaceuticals ; Teva Neuroscience, Inc. ; THERAKOS, Inc. ; and Wellpoint, Inc. ",
year = "2013",
month = may,
doi = "10.1016/j.bbmt.2013.01.004",
language = "English (US)",
volume = "19",
pages = "760--766",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",
number = "5",
}