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Hayden, P.J.; Eikema, D.J.; Wreede, L.C. de; Koster, L.; Kroger, N.; Einsele, H.; ... ; Yakoub-Agha, I. (2021)

Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party

Article / Letter to editor
The EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30-46%) at 2 years and 25% (17-32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24-46%); Others 9% (0-17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33-67%); Other 22% (8-36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21-40%) vs. 10% (1-20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24...Show moreThe EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30-46%) at 2 years and 25% (17-32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24-46%); Others 9% (0-17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33-67%); Other 22% (8-36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21-40%) vs. 10% (1-20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24-0.67), p < 0.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.Show less
All authors
Hayden, P.J.; Eikema, D.J.; Wreede, L.C. de; Koster, L.; Kroger, N.; Einsele, H.; Minnema, M.; Dominietto, A.; Potter, M.; Passweg, J.; Bermudez, A.; Nguyen-quoc, S.; Platzbecker, U.; Tischer, J.; Ciceri, F.; Veelken, J.H.; Ljungman, P.; Schaap, N.; Forcade, E.; Carella, A.M.; Gandemer, V.; Arcese, W.; Bloor, A.; Olivieri, A.; Vincent, L.; Beksac, M.; Schonland, S.; Yakoub-Agha, I.
Date
2021-05-11
Journal
Bone Marrow Transplantation
Volume
56
Issue
10
Pages
2367 - 2381
DOI
doi:10.1038/s41409-021-01286-x
Link
https://www.nature.com/articles/s41409-021-01286-x.pdf