Faculty Collaboration Database

Trends in allogeneic stem cell transplantation for multiple myeloma: a CIBMTR analysis. Blood 2011 Aug 18;118(7):1979-88

Date

06/22/2011

Pubmed ID

21690560

Pubmed Central ID

PMC3158724

DOI

10.1182/blood-2011-02-337329

Scopus ID

2-s2.0-80051878404 (requires institutional sign-in at Scopus site)   65 Citations

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).

Author List

Kumar S, Zhang MJ, Li P, Dispenzieri A, Milone GA, Lonial S, Krishnan A, Maiolino A, Wirk B, Weiss B, Freytes CO, Vogl DT, Vesole DH, Lazarus HM, Meehan KR, Hamadani M, Lill M, Callander NS, Majhail NS, Wiernik PH, Nath R, Kamble RT, Vij R, Kyle RA, Gale RP, Hari PN

Authors

Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Parameswaran Hari MD Adjunct 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

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

Adult
Aged
Cohort Studies
Female
Graft vs Host Disease
Humans
Male
Middle Aged
Multiple Myeloma
Stem Cell Transplantation
Survival Analysis
Transplantation, Homologous
Treatment Outcome
Young Adult