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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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Contribution to journal
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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
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yes
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de19a4a5-29f1-4245-9362-1c02d9fc41f3 (old id 239132)
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2007-08-20 16:21:59
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2017-09-10 03:47:40
@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},
  volume       = {105},
  year         = {2005},
}