Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: An analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT

Charles Crawley, Marc Lalancette, Richard Szydlo, Maria Gilleece, Karl Peggs, Stephen Mackinnon, Gunnar Juliusson, Lucia Ahlberg, Arnon Nagler, Avichai Shimoni, Anna Sureda, Jean Michel Boiron, Herman Einsele, Rajesh Chopra, Angelo Carella, Jamie Cavenagh, Alois Gratwohl, Frederic Garban, Axel Zander, Bo BjörkstrandDietger Niederwieser, Gösta Gahrton, Jane F. Apperley

Research output: Contribution to journalArticle

Abstract

We report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21%, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (RR, 1.45). Adverse PFS was associated with chemoresistance (RR, 2.4) and alemtuzumab (RR, 1.8). TRM was increased with female-tomale donation (RR, 2.5) and transplantation more than 1 year from diagnosis (RR, 2.3). Grades II to IV acute graft-versus-host disease (aGvHD) occurred in 31%. Chronic GvHD was associated with better OS and PFS and were 84% and 46% for limited, 58% and 30% for extensive, and 29% and 12% in its absence suggesting that a graft-versus-myeloma effect is important. While RIC is feasible, heavily pretreated patients and patients with progressive disease do not benefit.

Original languageEnglish
Pages (from-to)4532-4539
Number of pages8
JournalBlood
Volume105
Issue number11
DOIs
Publication statusPublished - Jun 1 2005

ASJC Scopus subject areas

  • Hematology

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    Crawley, C., Lalancette, M., Szydlo, R., Gilleece, M., Peggs, K., Mackinnon, S., Juliusson, G., Ahlberg, L., Nagler, A., Shimoni, A., Sureda, A., Boiron, J. M., Einsele, H., Chopra, R., Carella, A., Cavenagh, J., Gratwohl, A., Garban, F., Zander, A., ... Apperley, J. F. (2005). Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: An analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT. Blood, 105(11), 4532-4539. https://doi.org/10.1182/blood-2004-06-2387