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Bone Marrow Transplant. 2015 Jun;50(6):802-7. doi: 10.1038/bmt.2015.45. Epub 2015 Mar 23.

Comparison of upfront tandem autologous-allogeneic transplantation versus reduced intensity allogeneic transplantation for multiple myeloma.

Author information

1
1] City of Hope, Duarte, CA, USA [2] Southern California Kaiser Permanente, Los Angeles, CA, USA.
2
Università Tor Vergata, Roma, Italy.
3
EBMT, University Medical Center, Leiden, Netherlands.
4
Helsinki University Central Hospital, Helsinki, Finland.
5
University Hospital, Heidelberg, Germany.
6
Hôpital E. Herriot, Lyon, France.
7
Karolinska University Hospital Huddinge, Stockholm, Sweden.
8
Radboud University Medical Centre, Nijmegen, Netherlands.
9
Hospital Universitario, Salamanca, Spain.
10
Cliniques Universitaires Saint-Luc, Brussels, Belgium.
11
University Hospital, Basel, Switzerland.
12
Centre Pierre et Marie Curie, Alger, Algeria.
13
City of Hope, Duarte, CA, USA.
14
University Hospital Heidelberg, Heidelberg, Germany.
15
Queens University of Belfast, Belfast, Northern Ireland.
16
University Medical Center, Hamburg, Germany.
17
Hôpital Saint Antoine, Paris, France.

Abstract

We performed a retrospective analysis of the European Group for Blood and Marrow Transplantation database comparing the outcomes of multiple myeloma patients who received tandem autologous followed by allogeneic PSCT (auto-allo) with the outcomes of patients who underwent a reduced intensity conditioning allograft (early RIC) without prior autologous transplant. From 1996 to 2013, we identified a total of 690 patients: 517 patients were planned to receive auto-allo and 173 received an early RIC allograft without prior autologous transplant. With a median follow-up of 93 months, 5-year PFS survival was significantly better in the auto-allo group, 34% compared with 22% in the early RIC group (P<0.001). OS was also significantly improved in the auto-allo group with a 5-year rate of 59% vs 42% in the early RIC group (P=0.001). The non-relapse mortality rate was lower in the auto-allo group than in the early RIC group, with 1- and 3-year rates of 8% and 13% vs 20% and 28%, respectively (P<0.001). The relapse/progression rate was similar in the two groups, with 5-year rates of 50% for auto-allo and 46% for early RIC (P=0.42). These data suggest that planned tandem autologous allograft can improve overall survival compared with upfront RIC allograft alone in patients with multiple myeloma.

PMID:
25798673
DOI:
10.1038/bmt.2015.45
[Indexed for MEDLINE]

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