Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party

Author:

Hayden Patrick J.ORCID,Eikema Dirk-Jan,de Wreede Liesbeth C.,Koster Linda,Kröger Nicolaus,Einsele Hermann,Minnema Monique,Dominietto Alida,Potter Michael,Passweg Jacob,Bermúdez Arancha,Nguyen-quoc Stephanie,Platzbecker Uwe,Tischer Johanna,Ciceri Fabio,Veelken Joan HendrikORCID,Ljungman PerORCID,Schaap Nicolaas,Forcade EdouardORCID,Carella Angelo Michele,Gandemer Virginie,Arcese WilliamORCID,Bloor AdrianORCID,Olivieri Attilio,Vincent LaureORCID,Beksac Meral,Schönland StefanORCID,Yakoub-Agha IbrahimORCID

Abstract

AbstractThe EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30–46%) at 2 years and 25% (17–32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24–46%); Others 9% (0–17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33–67%); Other 22% (8–36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21–40%) vs. 10% (1–20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24–0.67), p < 0.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.

Publisher

Springer Science and Business Media LLC

Subject

Transplantation,Hematology

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