TY - JOUR
T1 - Trends in allogeneic Stem cell transplantation for multiple myeloma
T2 - A CIBMTR analysis
AU - Kumar, Shaji
AU - Zhang, Mei Jie
AU - Li, Peigang
AU - Dispenzieri, Angela
AU - Milone, Gustavo A.
AU - Lonial, Sagar
AU - Krishnan, Amrita
AU - Maiolino, Angelo
AU - Wirk, Baldeep
AU - Weiss, Brendan
AU - Freytes, César O.
AU - Vogl, Dan T.
AU - Vesole, David H.
AU - Lazarus, Hillard M.
AU - Meehan, Kenneth R.
AU - Hamadani, Mehdi
AU - Lill, Michael
AU - Callander, Natalie S.
AU - Majhail, Navneet S.
AU - Wiernik, Peter H.
AU - Nath, Rajneesh
AU - Kamble, Rammurti T.
AU - Vij, Ravi
AU - Kyle, Robert A.
AU - Gale, Robert Peter
AU - Hari, Parameswaran N.
PY - 2011/8/18
Y1 - 2011/8/18
N2 - Allogeneic hematopoietic cell transplantation in multiple myeloma is limited by prior reports of high treatment-related mortality. We analyzed outcomes after allogeneic hematopoietic cell transplantation for multiple myeloma in 1207 recipients in 3 cohorts based on the year of transplantation: 1989-1994 (n ∇ 343), 1995-2000 (n ∇ 376), and 2001-2005 (n ∇ 488). The most recent cohort was significantly older (53% > 50 years) and had more recipients after prior autotransplantation. Use of unrelated donors, reduced-intensity conditioning and the blood cell grafts increased over time. Rates of acute graft-versus-host (GVHD) were similar, but chronic GVHD rates were highest in the most recent cohort. Overall survival (OS) at 1-year increased over time, reflecting a decrease in treatment-related mortality, but 5-year relapse rates increased from 39% (95% confidence interval [CI], 33%-44%) in 1989-1994 to 58% (95% CI, 51%-64%; P < .001) in the 2001-2005 cohort. Projected 5-year progression-free survival and OS are 14% (95% CI, 9%-20%) and 29% (95% CI, 23%-35%), respectively, in the latest cohort. Increasing age, longer interval from diagnosis to transplantation, and unrelated donor grafts adversely affected OS in multivariate analysis. Survival at 5 years for subjects with none, 1, 2, or 3 of these risk factors were 41% (range, 36%-47%), 32% (range, 27%-37%), 25% (range, 19%-31%), and 3% (range, 0%-11%), respectively (P < .0001).
AB - Allogeneic hematopoietic cell transplantation in multiple myeloma is limited by prior reports of high treatment-related mortality. We analyzed outcomes after allogeneic hematopoietic cell transplantation for multiple myeloma in 1207 recipients in 3 cohorts based on the year of transplantation: 1989-1994 (n ∇ 343), 1995-2000 (n ∇ 376), and 2001-2005 (n ∇ 488). The most recent cohort was significantly older (53% > 50 years) and had more recipients after prior autotransplantation. Use of unrelated donors, reduced-intensity conditioning and the blood cell grafts increased over time. Rates of acute graft-versus-host (GVHD) were similar, but chronic GVHD rates were highest in the most recent cohort. Overall survival (OS) at 1-year increased over time, reflecting a decrease in treatment-related mortality, but 5-year relapse rates increased from 39% (95% confidence interval [CI], 33%-44%) in 1989-1994 to 58% (95% CI, 51%-64%; P < .001) in the 2001-2005 cohort. Projected 5-year progression-free survival and OS are 14% (95% CI, 9%-20%) and 29% (95% CI, 23%-35%), respectively, in the latest cohort. Increasing age, longer interval from diagnosis to transplantation, and unrelated donor grafts adversely affected OS in multivariate analysis. Survival at 5 years for subjects with none, 1, 2, or 3 of these risk factors were 41% (range, 36%-47%), 32% (range, 27%-37%), 25% (range, 19%-31%), and 3% (range, 0%-11%), respectively (P < .0001).
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U2 - 10.1182/blood-2011-02-337329
DO - 10.1182/blood-2011-02-337329
M3 - Article
C2 - 21690560
AN - SCOPUS:80051878404
SN - 0006-4971
VL - 118
SP - 1979
EP - 1988
JO - Blood
JF - Blood
IS - 7
ER -