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Conditioning Regimens

Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation

Bone Marrow Transplantation volume 48, pages 1395–1400 (2013)Cite this article

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Abstract

Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the treatment of relapse/progression after prior auto-SCT. Median age at RIC allo-SCT was 54.1 years, and 44.6% of patients had undergone two or more prior auto-SCTs. Median OS and PFS from the time of RIC allo-SCT for the entire population were 24.7 and 9.6 months, respectively. Cumulative non-relapse mortality (NRM) at 1 year was 21.5%. In multivariate analysis, CMV seronegativity of both patient and donor was associated with significantly better PFS, OS and NRM. Patient–donor gender mismatch was associated with better PFS, fewer than two prior auto-SCT was associated with better OS, and shorter time from the first auto-SCT to the RIC allo-SCT was associated with lower NRM. The results of this study identify patient and donor CMV seronegativity as the key prognostic factor for outcome after RIC allo-SCT for MM relapsing or progressing after prior auto-SCT.

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Authors and Affiliations

  1. Department of Medicine, Centre for Haematology, Hammersmith Hospital Campus, Imperial College London, London, UK

    H W Auner & R Szydlo

  2. Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands

    A van Biezen

  3. Centro di Biostatistica e Bioinformatica, Università Tor Vergata, Rome, Italy

    S Iacobelli

  4. Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden

    G Gahrton

  5. CHU Bordeaux, Hopital Haut-Leveque, Pessac, France

    N Milpied

  6. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    L Volin

  7. Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands

    J Janssen

  8. Department of Haematology, Groupe Hospitalier Pitié-Salpetriere, Paris, France

    S Nguyen Quoc

  9. BMT Unit Pavillon E, Hopital E Herriot, Lyon, France

    M Michallet

  10. Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium

    H Schoemans

  11. Unité de transplantation et thérapie cellulaire, Institut Paoli Calmettes, Marseille, France

    J el Cheikh

  12. Department of Haematology, University Medical Center, Utrecht, The Netherlands

    E Petersen

  13. Department of Bone Marrow Transplantation, Hopital La Miletrie, Poitiers, France

    F Guilhot

  14. Medizinische Klinik und Poliklinik V, University of Heidelberg, Heidelberg, Germany

    S Schönland

  15. Department of Haematology, University Hospital, Linköping, Sweden

    L Ahlberg

  16. Queens University, Belfast, UK

    C Morris

  17. Hopital Saint Antoine, Paris, France

    L Garderet

  18. Department of Tumor Immunology, Radboud University Medical Center, Nijmegen, The Netherlands

    T de Witte

  19. University Hospital Eppendorf, Hamburg, Germany

    N Kröger

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on behalf of the Plasma Cell Dyscrasia Sub-committee of the Chronic Malignancies Working Party of the European Group for Blood and Marrow Transplantation (EBMT)

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Correspondence to H W Auner.

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Author contributions

HWA was the principal investigator, designed the study, analysed data and wrote the paper. RS analysed data and revised the manuscript. AvB and SI contributed to the data analysis and revised the manuscript. GG, CM, SS, TdW, LG and NK contributed to study design and data interpretation, and revised the manuscript. NM, LV, JJ, SNQ, MM, HS, JeC, EP and FG provided patient care and documentation, and revised the manuscript.

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Auner, H., Szydlo, R., van Biezen, A. et al. Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 48, 1395–1400 (2013). https://doi.org/10.1038/bmt.2013.73

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