Conditioning-based outcomes after allogeneic transplantation for myeloma following a prior autologous transplant (1991-2012) on behalf of EBMT CMWP
Hayden, Patrick J; Iacobelli, Simona; Pérez-Simón, José Antonio; van Biezen, Anja; Minnema, Monique; Niittyvuopio, Riitta; Schönland, Stefan; Meijer, Ellen; Blaise, Didier; Milpied, Noel; Márquez-Malaver, Francisco J; Veelken, Joan Hendrik; Maertens, Johan; Michallet, Mauricette; Cammenga, Jörg; N'Guyen, Stephanie; Niederwieser, Dietger; Hunault-Berger, Mathilde; Henri Bourhis, Jean; Passweg, Jakob; Bermudez, Arancha; Chalandon, Yves; Yakoub-Agha, Ibrahim; Garderet, Laurent; Kröger, Nicolaus
(2020) European Journal of Haematology, volume 104, issue 3, pp. 181 - 189
(Article)
Abstract
Objectives: The aim of this study was to compare the effect of the intensity of conditioning approaches used in allogeneic transplantation in myeloma—reduced intensity conditioning (RIC), non-myeloablative (NMA), myeloablative conditioning (MAC) or Auto-AlloHCT—on outcomes in patients who had had a prior autologous transplant. Methods: A retrospective analysis of the EBMT database
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(1991-2012) was performed. Results: A total of 344 patients aged between 40 and 60 years at the time of alloHCT were identified: 169 RIC, 69 NMA, 65 MAC and 41 Auto-Allo transplants. At a median follow-up of 54 months, the probabilities of overall survival (OS) at 5 years were 39% (95% CI 31%-47%), 45% (95% CI 32%-57%), 19% (95% CI 6%-32%) and 34% (95% CI 17%-51%), respectively. Status at allogeneic HCT other than CR or PR conferred a 70% higher risk of death and a 40% higher risk of relapse. OS was markedly lower in the MAC group (P =.004). MAC alloHCT was associated with a higher risk of death than RIC alloHCT until 2002 (HR = 4.1, P <.001) but not after 2002 (HR = 1.2, P =.276). Conclusion: From 1991 to 2002, MAC was associated with poorer OS. Between 2003 and 2012, there were no significant differences in outcomes based on these different approaches.
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Keywords: allogeneic transplantation, CMWP, conditioning, EBMT, myeloma, Hematology, Journal Article
ISSN: 0902-4441
Publisher: Wiley-Blackwell
Note: Publisher Copyright: © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
(Peer reviewed)