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Leukemia. 2019 Nov;33(11):2710-2719. doi: 10.1038/s41375-019-0537-2. Epub 2019 Aug 28.

Allogeneic transplantation in multiple myeloma: long-term follow-up and cytogenetic subgroup analysis.

Author information

1
Department of Internal Medicine II, Division of Hematology and Medical Oncology, Würzburg University Medical Centre, Würzburg, Germany.
2
Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Centre, Freiburg, Germany.
3
Klinik für Innere Medizin III, Ulm University Hospital, Ulm, Germany.
4
Institute for Clinical Epidemiology and Applied Biometry, Tübingen University Medical School, Tübingen, Germany.
5
Department of Hematology and Oncology, University of Regensburg, Regensburg, Germany.
6
University Clinic for Internal Medicine - Oncology and Haematology, Oldenburg, Germany.
7
Department of Hematology, Oncology and Haemostaseology, Hanover Medical School, Hanover, Germany.
8
Medical Centre, Robert-Bosch-Hospital, Stuttgart, Germany.
9
Hematology, Oncology and Infectiology, Munich Schwabing Hospital, Munich, Germany.
10
Department of Hematology and Oncology, Centre of Internal Medicine, Otto-von-Guericke University, Magdeburg, Germany.
11
Department of Hematology/Oncology, Charite - Oncology Centre, Berlin, Germany.
12
Hematology and Oncology, Red Cross Hospital, Munich, Germany.
13
Department of Hematology, University Hospital Grosshadern, Munich, Germany.
14
IIIrd Department of Internal Medicine, Hematology/Oncology, Technical University, Munich, Germany.
15
Department of Hematology, Oncology and Pneumology, Universitätsmedizin Mainz, Mainz, Germany.
16
Department of Internal Medicine I, Klinikum Bremen Mitte, Bremen, Germany.
17
Hematology, Oncology, Palliative Medicine, University of Rostock, Rostock, Germany.
18
Hematology and Oncology, University of Munster, Munster, Germany.
19
Department of Internal Medicine, Greifswald University Hospital, Greifswald, Germany.
20
Department of Hematology and Oncology, University Hospital, Halle, Germany.
21
Hematology and Oncology, Zentrum Innere Medizin, Gottingen, Germany.
22
Hematology/Oncology, HSK, Dr. Horst-Schmidt-Klinik, Wiesbaden, Germany.
23
Department of Laboratory Medicine, CAST, Karolinska Institutet and University Hospital, Stockholm, Sweden.
24
Department of Hematology and Oncology, Charité University Hospital, Berlin, Germany.
25
Department of Hematology, Oncology and Palliative Care, Ernst von Bergmann Hospital, Potsdam, Germany.
26
Bolzano Municipal Hospital, Bolzano, Italy.
27
Department of Stem Cell Transplantation and Immunotherapy, Schleswig-Holstein University Hospital, Kiel Campus, Kiel, Germany.
28
Department of Internal Medicine, Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany.
29
Department for Oncology, Hematology, Immunology, Rheumatology and Pneumology, University Hospital, Tübingen, Germany.
30
Department of Internal Medicine II, Division of Hematology and Medical Oncology, Würzburg University Medical Centre, Würzburg, Germany. einsele_h@ukw.de.

Abstract

This phase 3 trial compared tandem autologous stem cell transplantation (autoSCT) versus autoSCT followed by reduced-intensity conditioning allogeneic stem cell transplantation (auto/alloSCT) in patients with newly diagnosed multiple myeloma (MM) with deletion of (del) chromosome 13q (del13q). The availability/absence of a human leukocyte antigen-matched-related or matched-unrelated donor (MUD) determined the nature of the second SCT. The primary endpoint was progression-free survival (PFS) in the intention-to-treat population (n = 199). Auto/alloSCT was performed in 126 patients; 74 received MUD allografts. After 91 months median follow-up, median PFS with auto/allo versus tandem autoSCT was 34.5 versus 21.8 months (P = 0.003; adjusted hazard ratio 0.55, 95% confidence interval 0.36-0.84). Median overall survival (OS) was 70.2 versus 71.8 months (P = 0.856). Two-year non-relapse mortality with auto/allo versus tandem autoSCT was 14.3% versus 4.1% (P = 0.008). In patients harboring both del13q and del17p, median PFS and OS were 37.5 and 61.5 months with auto/allo (n = 19) versus 6.1 and 23.4 months with tandem autoSCT (n = 6) (P = 0.0002 and 0.032). Our findings suggest that auto/alloSCT significantly extends PFS versus tandem autoSCT in del13q MM, and indicate some survival benefit for first-line alloSCT in high-risk MM.

PMID:
31462732
DOI:
10.1038/s41375-019-0537-2

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