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. Wiernik & 6 others Rajneesh Nath, Rammurti T. Kamble, Ravi Vij, Robert A. Kyle, Robert Peter Gale, Parameswaran N. Hari

Research output: Contribution to journalArticle

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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

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Stem Cell Transplantation
Stem cells
Multiple Myeloma
Grafts
Confidence Intervals
Unrelated Donors
Cell Transplantation
Transplants
Transplantation (surgical)
Transplantation
Mortality
Autologous Transplantation
Blood
Cells
Disease-Free Survival
Blood Cells
Multivariate Analysis
Recurrence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Kumar, S., Zhang, M. J., Li, P., Dispenzieri, A., Milone, G. A., Lonial, 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
Kumar, Shaji ; Zhang, Mei Jie ; Li, Peigang ; Dispenzieri, Angela ; Milone, Gustavo A. ; Lonial, Sagar ; Krishnan, Amrita ; Maiolino, Angelo ; Wirk, Baldeep ; Weiss, Brendan ; Freytes, César O. ; Vogl, Dan T. ; Vesole, David H. ; Lazarus, Hillard M. ; Meehan, Kenneth R. ; Hamadani, Mehdi ; Lill, Michael ; Callander, Natalie S. ; Majhail, Navneet S. ; Wiernik, Peter H. ; Nath, Rajneesh ; Kamble, Rammurti T. ; Vij, Ravi ; Kyle, Robert A. ; Gale, Robert Peter ; Hari, Parameswaran N. / Trends in allogeneic Stem cell transplantation for multiple myeloma : A CIBMTR analysis. In: Blood. 2011 ; Vol. 118, No. 7. pp. 1979-1988.
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title = "Trends in allogeneic Stem cell transplantation for multiple myeloma: A CIBMTR analysis",
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 = "Shaji Kumar and Zhang, {Mei Jie} and Peigang Li and Angela Dispenzieri and Milone, {Gustavo A.} and Sagar Lonial and Amrita Krishnan and Angelo Maiolino and Baldeep Wirk and Brendan Weiss and Freytes, {C{\'e}sar O.} and Vogl, {Dan T.} and Vesole, {David H.} and Lazarus, {Hillard M.} and Meehan, {Kenneth R.} and Mehdi Hamadani and Michael Lill and Callander, {Natalie S.} and Majhail, {Navneet S.} and Wiernik, {Peter H.} and Rajneesh Nath and Kamble, {Rammurti T.} and Ravi Vij and Kyle, {Robert A.} and Gale, {Robert Peter} and Hari, {Parameswaran N.}",
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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 2011, 'Trends in allogeneic Stem cell transplantation for multiple myeloma: A CIBMTR analysis', Blood, vol. 118, no. 7, pp. 1979-1988. https://doi.org/10.1182/blood-2011-02-337329

Trends in allogeneic Stem cell transplantation for multiple myeloma : A CIBMTR analysis. / Kumar, Shaji; Zhang, Mei Jie; Li, Peigang; Dispenzieri, Angela; Milone, Gustavo A.; Lonial, Sagar; Krishnan, Amrita; Maiolino, Angelo; Wirk, Baldeep; Weiss, Brendan; Freytes, César O.; Vogl, Dan T.; Vesole, David H.; Lazarus, Hillard M.; Meehan, Kenneth R.; Hamadani, Mehdi; Lill, Michael; Callander, Natalie S.; Majhail, Navneet S.; Wiernik, Peter H.; Nath, Rajneesh; Kamble, Rammurti T.; Vij, Ravi; Kyle, Robert A.; Gale, Robert Peter; Hari, Parameswaran N.

In: Blood, Vol. 118, No. 7, 18.08.2011, p. 1979-1988.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Trends in allogeneic Stem cell transplantation for multiple myeloma

T2 - A CIBMTR analysis

AU - Kumar, Shaji

AU - Zhang, Mei Jie

AU - Li, Peigang

AU - Dispenzieri, Angela

AU - Milone, Gustavo A.

AU - Lonial, Sagar

AU - Krishnan, Amrita

AU - Maiolino, Angelo

AU - Wirk, Baldeep

AU - Weiss, Brendan

AU - Freytes, César O.

AU - Vogl, Dan T.

AU - Vesole, David H.

AU - Lazarus, Hillard M.

AU - Meehan, Kenneth R.

AU - Hamadani, Mehdi

AU - Lill, Michael

AU - Callander, Natalie S.

AU - Majhail, Navneet S.

AU - Wiernik, Peter H.

AU - Nath, Rajneesh

AU - Kamble, Rammurti T.

AU - Vij, Ravi

AU - Kyle, Robert A.

AU - Gale, Robert Peter

AU - Hari, Parameswaran N.

PY - 2011/8/18

Y1 - 2011/8/18

N2 - 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).

AB - 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).

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Kumar S, Zhang MJ, Li P, Dispenzieri A, Milone GA, Lonial S et al. Trends in allogeneic Stem cell transplantation for multiple myeloma: A CIBMTR analysis. Blood. 2011 Aug 18;118(7):1979-1988. https://doi.org/10.1182/blood-2011-02-337329