TY - JOUR
T1 - Reduced-Intensity Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed Multiple Myeloma
AU - Efebera, Yvonne A.
AU - Qureshi, Sofia R.
AU - Cole, Suzanne M.
AU - Saliba, Rima
AU - Pelosini, Matteo
AU - Patel, Ronak M.
AU - Koca, Ebru
AU - Mendoza, Floralyn L.
AU - Wang, Michael
AU - Shah, Jatin
AU - Alousi, Amin
AU - Hosing, Chitra
AU - Popat, Uday
AU - Kebriaei, Partow
AU - Anderlini, Paolo
AU - Khouri, Issa F.
AU - Champlin, Richard
AU - Giralt, Sergio
AU - Qazilbash, Muzaffar H.
PY - 2010/8
Y1 - 2010/8
N2 - 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.
AB - 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.
KW - Multiple myeloma
KW - Reduce intensity allogeneic transplant
KW - Relapse/refractory
UR - http://www.scopus.com/inward/record.url?scp=77954311840&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954311840&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2010.02.015
DO - 10.1016/j.bbmt.2010.02.015
M3 - Article
C2 - 20178853
AN - SCOPUS:77954311840
SN - 1083-8791
VL - 16
SP - 1122
EP - 1129
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 8
ER -