Reduced-Intensity Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed Multiple Myeloma

Yvonne A. Efebera, Sofia R. Qureshi, Suzanne M. Cole, Rima Saliba, Matteo Pelosini, Ronak M. Patel, Ebru Koca, Floralyn L. Mendoza, Michael Wang, Jatin Shah, Amin Alousi, Chitra Hosing, Uday Popat, Partow Kebriaei, Paolo Anderlini, Issa F. Khouri, Richard Champlin, Sergio Giralt, Muzaffar H. Qazilbash

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Despite recent advances, multiple myeloma (MM) remains incurable, and most patients eventually develop progressive disease. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers a potentially curative option in 10%-20% of patients with relapsed or refractory disease. We evaluated the outcome of patients undergoing allo-HSCT with reduced-intensity conditioning (RIC) for relapsed and/or refractory MM at our institution. The study cohort included 51 patients with heavily pretreated, relapsed MM who underwent RIC allo-HSCT between 1996 and 2006. The median time from diagnosis to allo-HSCT was 34 months, and median follow-up in surviving patients was 27 months (range, 3-98 months). Cumulative transplantation-related mortality at 1 year was 25%. Progression-free survival (PFS) and overall survival (OS) at 2 years were 19% and 32%, respectively. The incidences of grade II-IV acute and chronic graft-versus-host disease were 27% and 47%, respectively. At the time of this analysis, 12 patients (24%) were alive, 7 of whom (14%) were in remission for up to 6 years after allo-HSCT. A lower β2 microglobulin level (<3.3) and previous autologous HSCT were predictive of lower nonrelapse mortality and longer PFS and OS. Our findings indicate that allo-HSCT with RIC is associated with acceptable toxicity and durable remission and survival in relapsed or refractory MM. The use of RIC allo-HSCT earlier in the course of the disease may offer the greatest benefit.

Original languageEnglish (US)
Pages (from-to)1122-1129
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume16
Issue number8
DOIs
StatePublished - Aug 2010

Keywords

  • Multiple myeloma
  • Reduce intensity allogeneic transplant
  • Relapse/refractory

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Efebera, Y. A., Qureshi, S. R., Cole, S. M., Saliba, R., Pelosini, M., Patel, R. M., Koca, E., Mendoza, F. L., Wang, M., Shah, J., Alousi, A., Hosing, C., Popat, U., Kebriaei, P., Anderlini, P., Khouri, I. F., Champlin, R., Giralt, S., & Qazilbash, M. H. (2010). Reduced-Intensity Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed Multiple Myeloma. Biology of Blood and Marrow Transplantation, 16(8), 1122-1129. https://doi.org/10.1016/j.bbmt.2010.02.015