Abstract:
: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).
journal_name
Bloodjournal_title
Bloodauthors
Kumar S,Zhang MJ,Li P,Dispenzieri A,Milone GA,Lonial S,Krishnan A,Maiolino A,Wirk B,Weiss B,Freytes CO,Vogl DT,Vesole DH,Lazarus HM,Meehan KR,Hamadani M,Lill M,Callander NS,Majhail NS,Wiernik PH,Nath R,Kamble RTdoi
10.1182/blood-2011-02-337329subject
Has Abstractpub_date
2011-08-18 00:00:00pages
1979-88issue
7eissn
0006-4971issn
1528-0020pii
blood-2011-02-337329journal_volume
118pub_type
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