TY - JOUR
T1 - Allogeneic hematopoietic cell transplantation from unrelated donors in multiple myeloma
T2 - Study from the italian bone marrow donor registry
AU - Passera, Roberto
AU - Pollichieni, Simona
AU - Brunello, Lucia
AU - Patriarca, Francesca
AU - Bonifazi, Francesca
AU - Montefusco, Vittorio
AU - Falda, Michele
AU - Montanari, Mauro
AU - Guidi, Stefano
AU - Giaccone, Luisa
AU - Mordini, Nicola
AU - Carella, Angelo Michele
AU - Bavaro, Pasqua
AU - Milone, Giuseppe
AU - Benedetti, Fabio
AU - Ciceri, Fabio
AU - Scimè, Rosanna
AU - Benedetti, Edoardo
AU - Castagna, Luca
AU - Festuccia, Moreno
AU - Rambaldi, Alessandro
AU - Bacigalupo, Andrea
AU - Corradini, Paolo
AU - Bosi, Alberto
AU - Boccadoro, Mario
AU - Bandini, Giuseppe
AU - Fanin, Renato
AU - Bruno, Benedetto
PY - 2013/6
Y1 - 2013/6
N2 - To evaluate trends in allografting from unrelated donors, we conducted a study on 196 consecutive myeloma patients transplanted between 2000 and 2009 in Italy. Twenty-eight percent, 37%, and 35%, respectively, received myeloablative, reduced-intensity, and nonmyeloablative conditioning. In these 3 cohorts, 1-year and 5-year transplantation-related mortalities were 28.8% and 37.0%, 20.3% and 31.3%, and 25.0% and 30.3%, respectively (. P = .745). Median overall survival (OS) and event-free survival from transplantation for the 3 cohorts were 29 and 10 months, 11 and 6 months, and 32 and 13 months, respectively (. P = .039 and P = .049). Overall cumulative incidences of acute and chronic graft-versus-host-disease (GVHD) were 46.1% and 51.1%. By Cox multivariate analyses, chronic GVHD was significantly associated with longer OS (hazard ratio [HR], .51; P = .009), whereas the use of peripheral blood stem cells was borderline significant (HR, .55; P = .051). Better response posttransplantation was associated with longer event-free survival (HR, 2.13 to 4.25; P <.001). Acute GVHD was associated with poorer OS (HR, 2.53; P = .001). This analysis showed a strong association of acute and chronic GVHD and depth of response posttransplantation with clinical outcomes. Long-term disease control remains challenging regardless of the conditioning. In the light of these results, prospective trials may be designed to better define the role of allografting from unrelated donors in myeloma.
AB - To evaluate trends in allografting from unrelated donors, we conducted a study on 196 consecutive myeloma patients transplanted between 2000 and 2009 in Italy. Twenty-eight percent, 37%, and 35%, respectively, received myeloablative, reduced-intensity, and nonmyeloablative conditioning. In these 3 cohorts, 1-year and 5-year transplantation-related mortalities were 28.8% and 37.0%, 20.3% and 31.3%, and 25.0% and 30.3%, respectively (. P = .745). Median overall survival (OS) and event-free survival from transplantation for the 3 cohorts were 29 and 10 months, 11 and 6 months, and 32 and 13 months, respectively (. P = .039 and P = .049). Overall cumulative incidences of acute and chronic graft-versus-host-disease (GVHD) were 46.1% and 51.1%. By Cox multivariate analyses, chronic GVHD was significantly associated with longer OS (hazard ratio [HR], .51; P = .009), whereas the use of peripheral blood stem cells was borderline significant (HR, .55; P = .051). Better response posttransplantation was associated with longer event-free survival (HR, 2.13 to 4.25; P <.001). Acute GVHD was associated with poorer OS (HR, 2.53; P = .001). This analysis showed a strong association of acute and chronic GVHD and depth of response posttransplantation with clinical outcomes. Long-term disease control remains challenging regardless of the conditioning. In the light of these results, prospective trials may be designed to better define the role of allografting from unrelated donors in myeloma.
KW - Allogeneic hematopoietic cell transplantation
KW - Multiple myeloma
KW - Unrelated donors
UR - http://www.scopus.com/inward/record.url?scp=84877895276&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877895276&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2013.03.012
DO - 10.1016/j.bbmt.2013.03.012
M3 - Article
C2 - 23538113
AN - SCOPUS:84877895276
VL - 19
SP - 940
EP - 948
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 6
ER -