Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 24, Issue 3, Pages 478-485Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2017.10.024
Keywords
Allogeneic transplantation; Myeloma; Relapse; Survival
Categories
Funding
- National Cancer Institute (NCI) [U24-CA076518]
- National Heart, Lung, and Blood Institute (NHLBI) [U24-CA076518]
- National Institute of Allergy and Infectious Diseases [U24-CA076518]
- NHLBI [5U10HL069294]
- NCI [5U10HL069294]
- Health Resources and Services Administration [HHSH250201200016C]
- Office of Naval Research [N00014-13-1-0039, N00014-14-1-0028]
- Actinium Pharmaceuticals
- Allos Therapeutics, Inc.
- Amgen, Inc.
- Ariad
- Be the Match Foundation
- Blue Cross and Blue Shield Association
- Celgene Corporation
- Chimerix, Inc.
- Fred Hutchinson Cancer Research Center
- Fresenius-Biotech North America, Inc.
- Gamida Cell Teva Joint Venture Ltd.
- Genentech, Inc.
- Gentium SpA
- Genzyme Corporation
- GlaxoSmithKline
- Health Research, Inc. Roswell Park Cancer Institute
- HistoGenetics, Inc.
- Incyte Corporation
- Jeff Gordon Children's Foundation
- Kiadis Pharma
- Leukemia & Lymphoma Society
- Medac GmbH
- Medical College of Wisconsin
- Merck Co, Inc.
- Millennium: The Takeda Oncology Co.
- Milliman USA, Inc.
- Miltenyi Biotec, Inc.
- National Marrow Donor Program
- Onyx Pharmaceuticals
- Optum Healthcare Solutions, Inc.
- Osiris Therapeutics, Inc.
- Otsuka America Pharmaceutical, Inc.
- Perkin Elmer, Inc.
- Remedy Informatics
- Sanofi US
- Seattle Genetics
- Sigma-Tau Pharmaceuticals
- Soligenix, Inc.
- St. Baldrick's Foundation
- StemCyte, A Global Cord Blood Therapeutics Co.
- Stemsoft Software, Inc.
- Swedish Orphan Biovitrum
- Tarix Pharmaceuticals
- TerumoBCT
- Teva Neuroscience, Inc.
- THERAKOS, Inc.
- University of Minnesota
- University of Utah
- Wellpoint, Inc.
- NATIONAL CANCER INSTITUTE [U24CA076518] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [U10HL069294] Funding Source: NIH RePORTER
Ask authors/readers for more resources
We compared postrelapse overall survival (OS) after autologous/allogeneic (auto/alto) versus tandem autologous (auto/auto) hematopoietic cell transplantation (HCT) in patients with multiple myeloma (MM). Postrelapse survival of patients receiving an auto/auto or auto/alto HCT for MM and prospectively reported to the Center for International Blood and Marrow Transplant Research between 2000 and 2010 were analyzed. Relapse occurred in 404 patients (72.4%) in the auto/auto group and in 178 patients (67.4%) in the auto/alto group after a median follow-up of 8.5 years. Relapse occurred before 6 months after a second HCT in 46% of the auto/ allo patients, compared with 26% of the auto/auto patients. The 6-year postrelapse survival was better in the auto/alto group compared with the auto/auto group (44% versus 35%; P=.05). Mortality due to MM was 69% (n=101) in the auto/allo group and 83% (n=229) deaths in auto/auto group. In multivariate analysis, both cohorts had a similar risk of death in the first year after relapse (hazard ratio [FIR],.72; P=.12); however, for time points beyond 12 months after relapse, overall survival was superior in the auto/allo cohort (HR for death in auto/auto=1.55; P=.005). Other factors associated with superior survival were enrollment in a clinical trial for HCT, male sex, and use of novel agents at induction before HCT. Our findings shown superior survival after relapse in auto/allo HCT recipients compared with auto/auto HCT recipients. This likely reflects a better response to salvage therapy, such as immunomodulatory drugs, potentiated by a donor-derived immunologic milieu. Further augmentation of the post-allo-HCT immune system with new immunotherapies, such as monoclonal antibodies, checkpoint inhibitors, and others, merit investigation. (C) 2017 American Society for Blood and Marrow Transplantation.
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