1. Outcome of allogeneic transplantation in newly diagnosed and relapsed/refractory multiple myeloma: long-term follow-up in a single institution.
- Author
-
Franssen, Laurens E., Raymakers, Reinier A. P., Buijs, Arjan, Schmitz, Marian F., Dorp, Suzanne, Mutis, Tuna, Lokhorst, Henk M., and Donk, Niels W. C. J.
- Subjects
- *
GRAFT versus host disease , *STEM cell transplantation , *MULTIPLE myeloma , *DISEASE remission , *PROTEASOME inhibitors , *CYTOGENETICS - Abstract
Allogeneic stem cell transplantation (allo- SCT) has the potential to induce long-term remission in multiple myeloma ( MM), but the role of allo- SCT in MM is controversial due to the high rate of treatment-related mortality ( TRM). However, although proteasome inhibitors and immunomodulatory drugs have improved the outcome of patients with MM, high-risk patients still have a very poor prognosis. This indicates the need for new treatment strategies and identification of patients who might benefit from allo- SCT. We therefore analyzed the outcome of one hundred and forty-seven patients with MM who received an allo- SCT at our institution (58 in first line, 89 in relapsed/refractory setting) after a median follow-up of 88.8 months. For the first-line setting, median progression-free survival ( PFS) and overall survival ( OS) were remarkably good, with a CR rate of 48.3%, median PFS of 30.2 months, and 10-yr OS of 51%. We found no difference in outcome for patients with high-risk metaphase cytogenetics or FISH del(13q14), but efficacy in current standard high-risk patients could not be determined. The outcome in the relapsed/refractory setting was poor, especially in the subgroup of patients relapsing within 18 months after auto- SCT. Therefore, if applied at all in these patients, improvement of allo- SCT is needed, focusing on reduction of TRM and more effective immunotherapy. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF