Faculty Collaboration Database

The outcome of unrelated donor stem cell transplantation for patients with multiple myeloma. Br J Haematol 2003 Dec;123(5):886-95

Date

11/25/2003

Pubmed ID

14632780

DOI

10.1046/j.1365-2141.2003.04714.x

Scopus ID

2-s2.0-10744222146 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

We performed a retrospective analysis of outcome in 45 patients with multiple myeloma receiving unrelated donor stem cell transplants (UD-SCT) in the UK between 1993 and 2002; 17 received myeloablative conditioning regimens and 28 received reduced intensity conditioning (RIC) protocols. Forty patients received pretransplant CAMPATH serotherapy. Forty-two of 45 patients had detectable disease at transplant, but 33 of 45 were chemoresponsive. Sixty per cent of patients had received a previous autograft. Myeloid engraftment was seen in 95% of recipients and was significantly faster in recipients receiving peripheral blood stem cells (P = 0.07) and RIC (P = 0.001). The incidence of severe (grade 3/4) acute graft versus host disease (aGvHD) was 5% (2/40). The 100-d non-relapse mortality was 18% (5/38) following RIC and 53% (9/17) following myeloablative regimens. Twenty-nine per cent of patients achieved a complete remission, 61% a partial remission, giving a 90% overall response rate. At median follow-up (513 d), overall survival was 40%: 54% in the RIC group (median follow-up: 489 d) and 18% in the myeloablative group (median follow-up: 560 d). In recipients of UD-SCT, RIC protocols that incorporated CAMPATH were associated with faster myeloid engraftment, less severe aGvHD and lower 100-d non-relapse mortality than myeloablative regimens, without a corresponding rise in relapse rate during the period of observation.

Author List

Shaw BE, Peggs K, Bird JM, Cavenagh J, Hunter A, Alejandro Madrigal J, Russell NH, Sirohi B, Towlson K, Williams CD, Marks DI, Clinical Trials Committee of the British Society of Blood and Marrow Transplantation

Author

Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of Wisconsin

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

Adult
Alemtuzumab
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antibodies, Neoplasm
Antineoplastic Agents
Cause of Death
Disease-Free Survival
Female
Humans
Male
Middle Aged
Multiple Myeloma
Proportional Hazards Models
Retrospective Studies
Stem Cell Transplantation
Transplantation Conditioning
Transplantation, Autologous
Treatment Outcome