title: Progress in allogenic bone marrow and peripheral blood stem cell transplantation for multiple myeloma: a comparison between transplants performed 1983--93 and 1994--8 at European Group for Blood and Marrow Transplantation centres.
abstract: Out of 690 allogeneic matched sibling donor transplants for multiple myeloma reported to the European Group for Blood and Marrow Transplantation (EBMT) registry, 334 were performed during the period 1983-93 (all with bone marrow) and 356 during 1994-98 [223 with bone marrow and 133 with peripheral blood stem cells (PBSCs)]. The median overall survival was 10 months for patients transplanted during the earlier time period and 50 months for patients transplanted with hone marrow during the later period. The use of PBSCs was associated with earlier engraftment but no significant survival benefit compared to bone marrow transplants during the same time period. The improvement in survival since 1994 with the result of a significant reduction in transplant-related mortality, which was 38%, 21% and 25% at 6 months and 46%, 30% and 37% at 2 years during the earlier period, and the later period with bone marrow and PBSCs respectively. Reasons for the reduced transplant-related mortality appeared to be fewer deaths owing to bacterial and fungal infections and interstitial pneumonitis, in turn a result of earlier transplantation and less prior chemotherapy. Better supportive treatment and more frequent use of cytokines may also play a role. The improvement in survival was not directly related to the increased use of PBSCs.
authors.affiliation: Department of Medicine, Huddinge Hospital, Sweden. gosta.gahrton@medhs.ki.se
authors.forename: G
authors.initials: G
authors.lastname: Gahrton
authors.forename: H
authors.initials: H
authors.lastname: Svensson
authors.forename: M
authors.initials: M
authors.lastname: Cavo
authors.forename: J
authors.initials: J
authors.lastname: Apperly
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: B
authors.initials: B
authors.lastname: Björkstrand
authors.forename: J
authors.initials: J
authors.lastname: Bladé
authors.forename: J
authors.initials: J
authors.lastname: Cornelissen
authors.forename: A
authors.initials: A
authors.lastname: de Laurenzi
authors.forename: T
authors.initials: T
authors.lastname: Facon
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.forename: D
authors.initials: D
authors.lastname: Niederwieser
authors.forename: R
authors.initials: R
authors.lastname: Powles
authors.forename: J
authors.initials: J
authors.lastname: Reiffers
authors.forename: N H
authors.initials: NH
authors.lastname: Russell
authors.forename: D
authors.initials: D
authors.lastname: Samson
authors.forename: U W
authors.initials: UW
authors.lastname: Schaefer
authors.forename: A
authors.initials: A
authors.lastname: Schattenberg
authors.forename: S
authors.initials: S
authors.lastname: Tura
authors.forename: L F
authors.initials: LF
authors.lastname: Verdonck
authors.forename: J P
authors.initials: JP
authors.lastname: Vernant
authors.forename: R
authors.initials: R
authors.lastname: Willemze
authors.forename: L
authors.initials: L
authors.lastname: Volin
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality / Q000639:trends*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D011336:Probability; D012042:Registries; D012074:Remission Induction; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome