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Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT

Crawley, C ; Lalancette, M ; Szydlo, R ; Gilleece, M ; Peggs, K ; Mackinnon, S ; Juliusson, Gunnar LU ; Ahlberg, L ; Nagler, A and Shimoni, A , et al. (2005) In Blood 105(11). p.4532-4539
Abstract
We report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRIM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21 %, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (FIR, 1.45). Adverse PFS... (More)
We report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRIM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21 %, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (FIR, 1.45). Adverse PFS was associated with chemoresistance (RR, 2.4) and alemtuzumab (RR, 1.8). TRM was increased with female-to-male donation (RR, 2.5) and transplantation more than 1 year from diagnosis (RR, 2.3). Grades II to IV acute graft-versus-host disease (aGvHD) occurred in 31%. Chronic GvHD was associated with better OS and PFS and were 84% and 46% for limited, 58% and 30% for extensive, and 29% and 12% in its absence suggesting that a graft-versus-myeloma effect is important. While RIC is feasible, heavily pretreated patients and patients with progressive disease do not benefit. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood
volume
105
issue
11
pages
4532 - 4539
publisher
American Society of Hematology
external identifiers
  • wos:000229292500060
  • pmid:15731182
  • scopus:21144446701
ISSN
1528-0020
DOI
10.1182/blood-2004-06-2387
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematology/Transplantation (013022014)
id
de19a4a5-29f1-4245-9362-1c02d9fc41f3 (old id 239132)
date added to LUP
2016-04-01 12:24:39
date last changed
2022-08-13 23:14:45
@article{de19a4a5-29f1-4245-9362-1c02d9fc41f3,
  abstract     = {{We report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRIM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21 %, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (FIR, 1.45). Adverse PFS was associated with chemoresistance (RR, 2.4) and alemtuzumab (RR, 1.8). TRM was increased with female-to-male donation (RR, 2.5) and transplantation more than 1 year from diagnosis (RR, 2.3). Grades II to IV acute graft-versus-host disease (aGvHD) occurred in 31%. Chronic GvHD was associated with better OS and PFS and were 84% and 46% for limited, 58% and 30% for extensive, and 29% and 12% in its absence suggesting that a graft-versus-myeloma effect is important. While RIC is feasible, heavily pretreated patients and patients with progressive disease do not benefit.}},
  author       = {{Crawley, C and Lalancette, M and Szydlo, R and Gilleece, M and Peggs, K and Mackinnon, S and Juliusson, Gunnar and Ahlberg, L and Nagler, A and Shimoni, A and Sureda, A and Boiron, JM and Einsele, H and Chopra, R and Carella, A and Cavenagh, J and Gratwohl, A and Garban, F and Zander, A and Bjorkstrand, B and Niederwieser, D and Gahrton, G and Apperley, JF}},
  issn         = {{1528-0020}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{4532--4539}},
  publisher    = {{American Society of Hematology}},
  series       = {{Blood}},
  title        = {{Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT}},
  url          = {{http://dx.doi.org/10.1182/blood-2004-06-2387}},
  doi          = {{10.1182/blood-2004-06-2387}},
  volume       = {{105}},
  year         = {{2005}},
}