Year: 2011
Type: article
Study design: Observational Study
Abstract: Allogeneic hematopoietic cell transplantation in multiple myeloma is limited by prior reports of high treatment-related mortality. We analyzed outcomes after allogeneic hematopoietic cell transplantation for multiple myeloma in 1207 recipients in 3 cohorts based on the year of transplantation: 1989-1994 (n = 343), 1995-2000 (n = 376), and 2001-2005 (n = 488). The most recent cohort was significantly older (53% > 50 years) and had more recipients after prior autotransplantation. Use of unrelated donors, reduced-intensity conditioning and the blood cell grafts increased over time. Rates of acute graft-versus-host (GVHD) were similar, but chronic GVHD rates were highest in the most recent cohort. Overall survival (OS) at 1-year increased over time, reflecting a decrease in treatment-related mortality, but 5-year relapse rates increased from 39% (95% confidence interval [CI], 33%-44%) in 1989-1994 to 58% (95% CI, 51%-64%; P < .001) in the 2001-2005 cohort. Projected 5-year progression-free survival and OS are 14% (95% CI, 9%-20%) and 29% (95% CI, 23%-35%), respectively, in the latest cohort. Increasing age, longer interval from diagnosis to transplantation, and unrelated donor grafts adversely affected OS in multivariate analysis. Survival at 5 years for subjects with none, 1, 2, or 3 of these risk factors were 41% (range, 36%-47%), 32% (range, 27%-37%), 25% (range, 19%-31%), and 3% (range, 0%-11%), respectively (P < .0001).
Source: Blood
Authors: Shaji Kumar, Mei-Jie Zhang, Peigang Li, Angela Dispenzieri, Gustavo A. Milone, Sagar Lonial, Amrita Krishnan, Angelo Maiolino, Baldeep Wirk, Brendan Weiss, César O. Freytes, Dan T. Vogl, David H. Vesole, Hillard M. Lazarus, Kenneth R. Meehan, Mehdi Hamadani, Michael Lill, Natalie S. Callander, Navneet S. Majhail, Peter H. Wiernik, Rajneesh Nath, Rammurti T. Kamble, Ravi Vij, Robert A. Kyle, Robert Peter Gale, Parameswaran N. Hari
Institutions: Mayo Clinic, Medical College of Wisconsin, Emory University Hospital, City Of Hope National Medical Center, Hospital Universitário Clementino Fraga Filho, University of Florida Health, University of Florida, Walter Reed National Military Medical Center, Abramson Cancer Center, University of Pennsylvania, Hackensack University Medical Center, University Hospitals Cleveland Medical Center, Dartmouth–Hitchcock Medical Center, West Virginia University Hospitals, Cedars-Sinai Medical Center, University of Wisconsin–Madison, UW Health University Hospital, University of Minnesota Medical Center, St. Luke's-Roosevelt Hospital Center, UMass Memorial Medical Center, Baylor College of Medicine, Barnes-Jewish Hospital, Celgene (United States)
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Defense, U.S. Department of Health and Human Services, Be The Match Foundation, Amgen, Pfizer, Astellas Pharma US, WellPoint, Biogen, Viropharma, Celgene, HistoGenetics, Osiris Therapeutics, Therakos, Blue Cross and Blue Shield Association, StemCyte, Medical College of Wisconsin, Sigma-Tau Pharmaceuticals, Otsuka America, CellGenix, Eisai, IC Design Education Center, Astellas Pharma, Health Resources and Services Administration, Genentech, U.S. Public Health Service, U.S. Navy, Takeda Oncology, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases
Awards: G327847204, G3609734018, G3822637944, G3939980515, G4619520382, G4928541993, G5080983006, G5393820452, G5685110365, G5699415455, G6749775408, BMT Clinical Research Network Data Coordinating Center, G7020281871, G8107732965, G833124618, G8876996369, G894505544, A Data Resource for Blood and Marrow Transplants and Adoptive Cellular Therapy Research, G909763084
OpenAlex ID: W2024036444