: The EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30-46%) at 2 years and 25% (17-32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24-46%); Others 9% (0-17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33-67%); Other 22% (8-36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21-40%) vs. 10% (1-20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24-0.67), p < 0.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.

Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party / Hayden, Patrick J; Eikema, Dirk-Jan; de Wreede, Liesbeth C; Koster, Linda; Kröger, Nicolaus; Einsele, Hermann; Minnema, Monique; Dominietto, Alida; Potter, Michael; Passweg, Jacob; Bermúdez, Arancha; Nguyen-Quoc, Stephanie; Platzbecker, Uwe; Tischer, Johanna; Ciceri, Fabio; Veelken, Joan Hendrik; Ljungman, Per; Schaap, Nicolaas; Forcade, Edouard; Carella, Angelo Michele; Gandemer, Virginie; Arcese, William; Bloor, Adrian; Olivieri, Attilio; Vincent, Laure; Beksac, Meral; Schönland, Stefan; Yakoub-Agha, Ibrahim. - In: BONE MARROW TRANSPLANTATION. - ISSN 1476-5365. - 56:10(2021), p. 2367-2381. [10.1038/s41409-021-01286-x]

Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party

Olivieri, Attilio;
2021-01-01

Abstract

: The EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30-46%) at 2 years and 25% (17-32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24-46%); Others 9% (0-17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33-67%); Other 22% (8-36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21-40%) vs. 10% (1-20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24-0.67), p < 0.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.
2021
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/294597
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