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Comparison of twin and autologous transplants for multiple myeloma. Biol Blood Marrow Transplant 2008 Oct;14(10):1118-1124 PMID: 18804041 PMCID: PMC2584240

Pubmed ID

18804041

Abstract

Relapse is the overwhelming cause of treatment failure after autologous transplantation for multiple myeloma (MM). For patients with a syngeneic donor, twin transplants provide a healthy graft that is free of myeloma. The relative impact of the graft on posttransplant relapse can be estimated by comparing risk of relapse after hematopoietic cell transplantation from genetically identical twins versus autotransplants because confounding differences in minor or major histocompatibility antigens are absent in the syngeneic transplant setting. Outcomes of 43 subjects who received twin transplants for MM were compared to 170 matched autotransplant recipients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Multivariate analysis was performed by fitting a Cox model stratified on matched pairs. The matched transplant patients studied were similar with respect to subject-, disease-, and transplant-related characteristics. Cumulative incidence of relapse/progression was significantly lower, and progression-free survival (PFS) was significantly higher following twin transplants. In multivariate analysis, the probability of relapse/progression was lower in twins (relative risk [RR] = 0.49, 95% confidence interval [CI] 0.28-0.86, P = .011). Twin transplants have a significantly lower relapse risk than autotransplants in MM, suggesting that graft composition may impact outcomes following high-dose chemotherapy.

Author List

Bashey A, PĂ©rez WS, Zhang MJ, Anderson KC, Ballen K, Berenson JR, To LB, Fonseca R, Freytes CO, Gale RP, Gibson J, Giralt SA, Kyle RA, Lazarus HM, Maharaj D, McCarthy PL, Milone GA, Nimer S, Pavlovsky S, Reece DE, Schiller G, Vesole DH, Hari P, Plasma Cell Disorders Working Committee

Authors

Parameswaran Hari MD Chief, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-51649085791   19 Citations

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Analysis of Variance
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Multiple Myeloma
Recurrence
Transplantation Immunology
Transplantation, Autologous
Transplantation, Isogeneic
Twins, Monozygotic
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6