Trends in allogeneic Stem cell transplantation for multiple myeloma: A CIBMTR analysis

Shaji Kumar, Mei Jie Zhang, Peigang Li, Angela Dispenzieri, Gustavo A. Milone, Sagar Lonial, Amrita Krishnan, Angelo Maiolino, Baldeep Wirk, Brendan Weiss, César O. Freytes, Dan T. Vogl, David H. Vesole, Hillard M. Lazarus, Kenneth R. Meehan, Mehdi Hamadani, Michael Lill, Natalie S. Callander, Navneet S. Majhail, Peter H. WiernikRajneesh Nath, Rammurti T. Kamble, Ravi Vij, Robert A. Kyle, Robert Peter Gale, Parameswaran N. Hari

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59 Scopus 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).

Original languageEnglish (US)
Pages (from-to)1979-1988
Number of pages10
JournalBlood
Volume118
Issue number7
DOIs
StatePublished - Aug 18 2011

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Kumar, S., Zhang, M. J., Li, P., Dispenzieri, A., Milone, G. A., Lonial, S., Krishnan, A., Maiolino, A., Wirk, B., Weiss, B., Freytes, C. O., Vogl, D. T., Vesole, D. H., Lazarus, H. M., Meehan, K. R., Hamadani, M., Lill, M., Callander, N. S., Majhail, N. S., ... Hari, P. N. (2011). Trends in allogeneic Stem cell transplantation for multiple myeloma: A CIBMTR analysis. Blood, 118(7), 1979-1988. https://doi.org/10.1182/blood-2011-02-337329