title: Alemtuzumab-based reduced-intensity conditioning allogeneic transplantation for myeloma and plasma cell leukemia - a single-institution experience.
abstract: BACKGROUND
  Reduced-intensity conditioning allogeneic transplantation for myeloma is associated with lower non-relapse mortality and higher relapse rates in comparison with myeloablative conditioning transplants.
  
  
  METHODS
  We have retrospectively audited 19 patients with myeloma or primary plasma cell leukemia who received allogeneic transplantation with a uniform alemtuzumab-based reduced-intensity conditioning protocol. These patients had not been treated with bortezomib or lenalidomide before transplantation.
  
  
  RESULTS
  The treatment-related mortality at 1 year was (4/19) 21% with low incidence of graft-versus-host disease (6%) and 2-year progression-free survival and overall survival rates of 35% and 42%, respectively.
  
  
  CONCLUSIONS
  Progression-free survival in this cohort of patients is comparable to previously published data of reduced-intensity conditioning allogeneic transplantation in myeloma. However, there is no plateau observed on the survival curves with a significant transplant-related mortality of 21%. Therefore, alemtuzumab-based allogeneic transplantation cannot be recommended as standard practice outside of clinical trials for treatment of myeloma.
authors.affiliation: Kings College Hospital NHS Foundation Trust, London, England. karthik.ramasamy@kcl.ac.uk
authors.forename: Karthik
authors.initials: K
authors.lastname: Ramasamy
authors.forename: Shameem
authors.initials: S
authors.lastname: Mahmood
authors.forename: Ziyi
authors.initials: Z
authors.lastname: Lim
authors.forename: Sophie
authors.initials: S
authors.lastname: Corderoy
authors.forename: Stephen
authors.initials: S
authors.lastname: Devereux
authors.forename: Ghulam J
authors.initials: GJ
authors.lastname: Mufti
authors.forename: Antonio
authors.initials: A
authors.lastname: Pagliuca
authors.forename: Stephen
authors.initials: S
authors.lastname: Schey
mesh_terms: D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D000074323:Alemtuzumab