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Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the treatment of relapse/progression after prior auto-SCT. Median age at RIC allo-SCT was 54.1 years, and 44.6% of patients had undergone two or more prior auto-SCTs. Median OS and PFS from the time of RIC allo-SCT for the entire population were 24.7 and 9.6 months, respectively. Cumulative non-relapse mortality (NRM) at 1 year was 21.5%. In multivariate analysis, CMV seronegativity of both patient and donor was associated with significantly better PFS, OS and NRM. Patient-donor gender mismatch was associated with better PFS, fewer than two prior auto-SCT was associated with better OS, and shorter time from the first auto-SCT to the RIC allo-SCT was associated with lower NRM. The results of this study identify patient and donor CMV seronegativity as the key prognostic factor for outcome after RIC allo-SCT for MM relapsing or progressing after prior auto-SCT. [ABSTRACT FROM AUTHOR]

Purpose Dynamic conformal radiotherapy with helical TomoTherapy ® (HT) offers a more quantitative paradigm for total body irradiation. Treatment planning, delivery, dose verification of the first French experiences of total body irradiation using helical TomoTherapy ® are presented. Materials and methods Patients planned for total body irradiation at our institution from February 2012 to May 2013 were reported. Total body irradiation consisted in a single fraction of 2 Gy. Planning target volume was divided in two due to the limited translation length of the table. Delivery quality assurance was performed with cylindrical phantom, ionization chamber and films. Thermoluminescent dosimeters and radiochromic films were used for in vivo dosimetry and junction region heterogeneity assessment. Results Six patients were included. One finally did not receive the treatment but dosimetric data were analyzed. Planned V 95% was covered by D 95% and V 2% did not exceed D 107% for five of the six patients. The mean relative difference between measured and calculated absolute dose of the Delivery quality assurance was always less than 2.5% (mean value ± SD : 1% ± 0.67%). Gamma index (3%; 3 mm) was less than 1 for at least 93% of the points (value ± SD : 97.4 ± 1.6% and 96.6 ± 2.5% for upper and lower part of treatment respectively). Difference between in vivo measured and calculated dose was above 5% for only two out of 15 points (maximum: 10.2%, mean: 0.73 ± 4.6%). Junction region heterogeneity was in average 5.8 ± 1%. The total treatment session of total body irradiation lasted 120 min, with a mean beam on time of 17.2 ± 0.6 and 11.2 ± 1.6 min for upper and lower part of the body respectively. Conclusion Total body irradiation using helical TomoTherapy ® guaranteed high dose homogeneity throughout the body and dose verification was achievable, showing small difference between planned and delivered doses. [ABSTRACT FROM AUTHOR]