Salvage autologous or allogeneic transplantation for multiple myeloma refractory to or relapsing after a first-line autograft?

Abstract:

:Forty-two patients allografted for multiple myeloma after not having attained at least a partial remission (n = 19) or after having experienced disease progression (n = 23) following one autograft were compared with 42 pair-matched controls who underwent salvage autotransplantation under identical conditions. Autografted controls were matched closely for albumin, C-reactive protein, creatinine, disease sensitivity, duration of standard therapy prior to the first transplant, Ig isotype, karyotype, LDH, and response to the first transplant, but, in comparison to allografted patients, were older, had higher beta2-microglobulin, and had a shorter interval between the two transplants. The complete remission rate was 41% after allogeneic and 33% after autologous transplantation (P = NS). The 3-year probability of event-free survival was comparable for the two groups (25 +/- 8% after autografting and 20 +/- 8% after allografting). The 3-year probability of survival was significantly higher after autologous transplantation (54 +/- 8% vs 29 +/- 9%; P = 0.01). Twenty-one patients in the autograft group were alive 11-59 months (median 32) following the second transplant, while 15 patients in the allograft group were alive at 10-53 months (median 20). The 3-year probability of disease progression was significantly lower after allogeneic transplantation (31 +/- 10% vs 72 +/- 9%, P = 0.03). The 1-year probability of transplant-related mortality was significantly higher after allografting (43 +/- 8% vs 10 +/- 5%; P = 0.0001). We conclude that while autografting appears to be superior to allografting for salvage therapy of myeloma persisting or relapsing after one previous autotransplant in terms of overall survival, event-free survival is comparable due to significantly lower disease progression after allografting. Reduction in allograft-related toxicity can potentially improve the results of allogeneic transplantation significantly.

journal_name

Bone Marrow Transplant

authors

Mehta J,Tricot G,Jagannath S,Ayers D,Singhal S,Siegel D,Desikan K,Munshi N,Fassas A,Mattox S,Vesole D,Crowley J,Barlogie B

doi

10.1038/sj.bmt.1701208

subject

Has Abstract

pub_date

1998-05-01 00:00:00

pages

887-92

issue

9

eissn

0268-3369

issn

1476-5365

journal_volume

21

pub_type

临床试验,杂志文章
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    authors: Gratwohl A,Baldomero H,John L,Gimmi C,Pless M,Tichelli A,Nissen C,Filipowicz A,Speck B

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    authors: Varadi G,Or R,Rund D,Orbach H,Slavin S,Nagler A

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  • The influence of early transplantation, age, GVHD prevention regimen, and other factors on outcome of allogeneic transplantation for CML following BuCy.

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  • Hematopoietic stem cell transplantation for adults with acute promyelocytic leukemia in the ATRA era: a survey of the European Cooperative Group for Blood and Marrow Transplantation.

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    pub_type: 杂志文章,多中心研究

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    更新日期:2007-04-01 00:00:00

  • Diagnosis of toxoplasmosis in bone marrow transplant recipients: comparison of PCR-based results and immunohistochemistry.

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1702457

    authors: Held TK,Krüger D,Switala AR,Beyer J,Kingreen D,Busemann C,Janitschke K,Siegert W

    更新日期:2000-06-01 00:00:00

  • Cardiac complications in patients undergoing a reduced-intensity conditioning hematopoietic stem cell transplantation.

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    pub_type: 杂志文章

    doi:10.1038/bmt.2009.97

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    pub_type: 杂志文章

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    更新日期:2001-03-01 00:00:00

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    doi:

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    pub_type: 杂志文章

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    更新日期:2014-02-01 00:00:00

  • Risk factors and prognosis of hepatic acute GvHD after allogeneic hematopoietic cell transplantation.

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    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1038/bmt.2015.205

    authors: Arai Y,Kanda J,Nakasone H,Kondo T,Uchida N,Fukuda T,Ohashi K,Kaida K,Iwato K,Eto T,Kanda Y,Nakamae H,Nagamura-Inoue T,Morishima Y,Hirokawa M,Atsuta Y,Murata M,GVHD working group of the Japan Society for Hematopoietic Ce

    更新日期:2016-01-01 00:00:00

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    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1038/sj.bmt.1700682

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    更新日期:1997-03-01 00:00:00

  • Tacrolimus and mycofenolate mofetil as GvHD prophylaxis following nonmyeloablative conditioning and unrelated hematopoietic SCT for adult patients with advanced hematologic diseases.

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    pub_type: 杂志文章

    doi:10.1038/bmt.2010.167

    authors: Zohren F,Schroeder T,Czibere A,Fenk R,Bruns I,Kondakci M,Saure C,Haas R,Kobbe G

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  • A randomized study comparing filgrastim versus lenograstim versus molgramostim plus chemotherapy for peripheral blood progenitor cell mobilization.

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,随机对照试验

    doi:10.1038/sj.bmt.1705465

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  • Immunological questions on hematopoietic stem cell transplantation for multiple sclerosis.

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,评审

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    authors: Muraro PA,Martin R

    更新日期:2003-08-01 00:00:00

  • Histoincompatibilities in ABDR-matched unrelated donor recipient combinations.

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Rufer N,Tiercy JM,Breur-Vriesendorp B,Gauchat-Feiss D,Shi X,Slavcev A,Lardy N,Speiser D,Gratwohl A,Chapuis B

    更新日期:1995-11-01 00:00:00

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1702636

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    更新日期:2000-10-01 00:00:00

  • Parenteral nutrition following intensive cytotoxic therapy: an exploratory study on the need for parenteral nutrition after various treatment approaches for haematological malignancies.

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    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1701747

    authors: Iestra JA,Fibbe WE,Zwinderman AH,Romijn JA,Kromhout D

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  • Evaluation of a monoclonal IgM antibody for purging of bone marrow for autologous transplantation.

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Zola H,Potter A,Neoh SH,Juttner CA,Haylock DN,Rice AM,Favaloro EJ,Kabral A,Bradstock KF

    更新日期:1987-02-01 00:00:00

  • Transplantation of allogeneic CD34-selected stem cells after fludarabine-based conditioning regimen for children with mucopolysaccharidosis 1H (M. Hurler).

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    更新日期:2005-02-01 00:00:00

  • Calcineurin inhibitor-free GVHD prophylaxis with sirolimus, mycophenolate mofetil and ATG in Allo-SCT for leukemia patients with high relapse risk: an observational cohort study.

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    更新日期:2009-05-01 00:00:00

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    pub_type: 杂志文章,评审

    doi:10.1038/sj.bmt.1702024

    authors: Karthaus M,Rosenthal C,Ganser A

    更新日期:1999-11-01 00:00:00

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    pub_type: 临床试验,杂志文章

    doi:10.1038/bmt.2014.226

    authors: St Bernard R,Chodirker L,Masih-Khan E,Jiang H,Franke N,Kukreti V,Tiedemann R,Trudel S,Reece D,Chen CI

    更新日期:2015-01-01 00:00:00

  • Plasmodium vivax malaria after autologous bone marrow transplantation: an unusual complication.

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    pub_type: 杂志文章

    doi:

    authors: Salutari P,Sica S,Chiusolo P,Micciulli G,Plaisant P,Nacci A,Antinori A,Leone G

    更新日期:1996-10-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1038/bmt.2015.88

    authors: Aversa F

    更新日期:2015-06-01 00:00:00

  • Progenitor and lymphoma cells in blood stem cell harvests: impact on survival following transplantation.

    abstract::This study evaluated whether cytokine-induced blood stem cell mobilization also mobilized lymphoma cells and whether lymphoma cell mobilization affected outcome post autologous blood stem cell transplant. Blood stem cell collections from 26 non-Hodgkin's lymphoma (NHL) patients harvested during steady-state (non-mobil...

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    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1703124

    authors: Demirkazik A,Kessinger A,Armitage JO,Bierman PJ,Lynch J,Vose J,Chan W,Sharp JG

    更新日期:2001-07-01 00:00:00

  • The evolution of clinical peripheral blood stem cell transplantation.

    abstract::Our growing physiological understanding of hematopoietic progenitor cells has led to the clinical use of circulating progenitor cells, including stem cells, for either reconstitution of hematopoietic function, up to the transduction of functional genes into a self-renewing cell system. In the following, an attempt has...

    journal_title:Bone marrow transplantation

    pub_type: 历史文章,杂志文章

    doi:

    authors: Körbling M,Fliedner TM

    更新日期:1996-05-01 00:00:00