OBJECTIVES: The aim of this study was to identify prognostic factors for outcome of high-risk patients with multiple myeloma after allogeneic transplantation prepared by reduced intensity conditioning (RIC). MATERIALS AND METHODS: Data from 45 consecutive patients (median age 52 years, range 38-68), who received grafts from a sibling (n = 34) or unrelated donor (n = 11) were analyzed. Fourteen patients received an RIC allotransplant while chemosensitive (>/=partial remission [PR]), whereas 31 chemoresistant patients (<PR) had either relapsed (n = 28) or were refractory (n = 3) after one or more autografts; of these 28 patients, 4 had secondary myelodysplasia concurrent with relapse. Of the 14 chemosensitive patients, 12 received an RIC allotransplant as consolidation after an autotransplant (AT). RESULTS: Twenty-nine (64%) were in a complete remission (CR) or near CR, 5 were in PR, and 5 had progressive disease. Twenty-five patients died, 17 of transplant-related complications, 7 of progressive disease, and 1 of a nontransplant-related cause. With a median follow-up of 15 months, the following factors were significantly associated with a better event-free survival (EFS) probability at 3 years: chemosensitive disease (64% vs 12%), pretransplant performance score (PS, Zubrod) </=2 (36% vs 0%), CR + near CR post transplant (36% vs 0%), and presence of chronic graft-vs-host disease (GVHD; 29% vs 0%). The same factors and absence of grade III to IV acute GVHD (52% vs 0%) were significant for a better overall survival (OS). On multivariate analysis including only pretransplant factors, both chemosensitive response and PS </=2 were significant for overall survival and event-free survival (p < 0.01). When response to RIC allotransplant and GVHD were added to the model, chronic GVHD was significant for better event-free survival, with an odds ratio of 1.5 (p < 0.01). CONCLUSIONS: Our data suggest that although RIC allotransplant induces high rates of CR and near CR, even in refractory disease, it appears to result in a durable response only if it is applied early in the disease in high-risk patients, when they still are chemosensitive and have an adequate PS.
OBJECTIVES: The aim of this study was to identify prognostic factors for outcome of high-risk patients with multiple myeloma after allogeneic transplantation prepared by reduced intensity conditioning (RIC). MATERIALS AND METHODS: Data from 45 consecutive patients (median age 52 years, range 38-68), who received grafts from a sibling (n = 34) or unrelated donor (n = 11) were analyzed. Fourteen patients received an RIC allotransplant while chemosensitive (>/=partial remission [PR]), whereas 31 chemoresistant patients (<PR) had either relapsed (n = 28) or were refractory (n = 3) after one or more autografts; of these 28 patients, 4 had secondary myelodysplasia concurrent with relapse. Of the 14 chemosensitive patients, 12 received an RIC allotransplant as consolidation after an autotransplant (AT). RESULTS: Twenty-nine (64%) were in a complete remission (CR) or near CR, 5 were in PR, and 5 had progressive disease. Twenty-five patients died, 17 of transplant-related complications, 7 of progressive disease, and 1 of a nontransplant-related cause. With a median follow-up of 15 months, the following factors were significantly associated with a better event-free survival (EFS) probability at 3 years: chemosensitive disease (64% vs 12%), pretransplant performance score (PS, Zubrod) </=2 (36% vs 0%), CR + near CR post transplant (36% vs 0%), and presence of chronic graft-vs-host disease (GVHD; 29% vs 0%). The same factors and absence of grade III to IV acute GVHD (52% vs 0%) were significant for a better overall survival (OS). On multivariate analysis including only pretransplant factors, both chemosensitive response and PS </=2 were significant for overall survival and event-free survival (p < 0.01). When response to RIC allotransplant and GVHD were added to the model, chronic GVHD was significant for better event-free survival, with an odds ratio of 1.5 (p < 0.01). CONCLUSIONS: Our data suggest that although RIC allotransplant induces high rates of CR and near CR, even in refractory disease, it appears to result in a durable response only if it is applied early in the disease in high-risk patients, when they still are chemosensitive and have an adequate PS.
Authors: A P Nair; P Walker; A Kalff; K Bergin; J Hocking; S Avery; D J Curtis; S Patil; T Das; D Klarica; S Morgan; J Muirhead; M Gorniak; J Reynolds; A Spencer Journal: Bone Marrow Transplant Date: 2017-03-20 Impact factor: 5.483
Authors: Yvonne A Efebera; Sofia R Qureshi; Suzanne M Cole; Rima Saliba; Matteo Pelosini; Ronak M Patel; Ebru Koca; Floralyn L Mendoza; Michael Wang; Jatin Shah; Amin Alousi; Chitra Hosing; Uday Popat; Partow Kebriaei; Paolo Anderlini; Issa F Khouri; Richard Champlin; Sergio Giralt; Muzaffar H Qazilbash Journal: Biol Blood Marrow Transplant Date: 2010-02-21 Impact factor: 5.742
Authors: George E Georges; Michael B Maris; David G Maloney; Brenda M Sandmaier; Mohamed L Sorror; Judith A Shizuru; Thoralf Lange; Edward D Agura; Benedetto Bruno; Peter A McSweeney; Michael A Pulsipher; Thomas R Chauncey; Marco Mielcarek; Barry E Storer; Rainer Storb Journal: Biol Blood Marrow Transplant Date: 2007-02-01 Impact factor: 5.742
Authors: Qaiser Bashir; Hassan Khan; Peter F Thall; Ping Liu; Nina Shah; Partow Kebriaei; Simrit Parmar; Betul Oran; Stefan Ciurea; Yago Nieto; Roy Jones; Chitra M Hosing; Uday R Popat; Yvonne T Dinh; Gabriela Rondon; Robert Z Orlowski; Jatin J Shah; Marcos De Lima; Elizabeth Shpall; Richard Champlin; Sergio Giralt; Muzaffar H Qazilbash Journal: Biol Blood Marrow Transplant Date: 2013-07-17 Impact factor: 5.742
Authors: Christoph Kahl; Barry E Storer; Brenda M Sandmaier; Marco Mielcarek; Michael B Maris; Karl G Blume; Dietger Niederwieser; Thomas R Chauncey; Stephen J Forman; Edward Agura; Jose F Leis; Benedetto Bruno; Amelia Langston; Michael A Pulsipher; Peter A McSweeney; James C Wade; Elliot Epner; Finn Bo Petersen; Wolfgang A Bethge; David G Maloney; Rainer Storb Journal: Blood Date: 2007-06-26 Impact factor: 22.113
Authors: David H Vesole; Lijun Zhang; Neal Flomenberg; Philip R Greipp; Hillard M Lazarus; Carol A Huff Journal: Biol Blood Marrow Transplant Date: 2009-01 Impact factor: 5.742