Allogeneic hematopoietic cell transplantation from unrelated donors in multiple myeloma: Study from the italian bone marrow donor registry

Roberto Passera, Simona Pollichieni, Lucia Brunello, Francesca Patriarca, Francesca Bonifazi, Vittorio Montefusco, Michele Falda, Mauro Montanari, Stefano Guidi, Luisa Giaccone, Nicola Mordini, Angelo Michele Carella, Pasqua Bavaro, Giuseppe Milone, Fabio Benedetti, Fabio Ciceri, Rosanna Scimè, Edoardo Benedetti, Luca Castagna, Moreno FestucciaAlessandro Rambaldi, Andrea Bacigalupo, Paolo Corradini, Alberto Bosi, Mario Boccadoro, Giuseppe Bandini, Renato Fanin, Benedetto Bruno

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)940-948
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number6
DOIs
Publication statusPublished - Jun 2013

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Keywords

  • Allogeneic hematopoietic cell transplantation
  • Multiple myeloma
  • Unrelated donors

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Passera, R., Pollichieni, S., Brunello, L., Patriarca, F., Bonifazi, F., Montefusco, V., Falda, M., Montanari, M., Guidi, S., Giaccone, L., Mordini, N., Carella, A. M., Bavaro, P., Milone, G., Benedetti, F., Ciceri, F., Scimè, R., Benedetti, E., Castagna, L., ... Bruno, B. (2013). Allogeneic hematopoietic cell transplantation from unrelated donors in multiple myeloma: Study from the italian bone marrow donor registry. Biology of Blood and Marrow Transplantation, 19(6), 940-948. https://doi.org/10.1016/j.bbmt.2013.03.012