title: Long-term outcome after allogeneic stem-cell transplantation with reduced-intensity conditioning in patients with multiple myeloma.
abstract: This study examines the long-term outcomes of a cohort of patients with myeloma who were treated with reduced-intensity conditioning (RIC) regimens after a minimum follow-up of 5 years at our centre. A total of 53 patients with multiple myeloma (MM) who received allogeneic hematopoietic stem-cell transplantation (Allo-SCT) between January 2000 and January 2007 were identified. The median follow-up of living patients was 84 months (51-141). The median age of the MM patients was 50 (28-70) years. Fifty-one patients (96%) received a transplant from a sibling donor. The median time between diagnosis and Allo-SCT was 34 months (6-161), and the median time between auto-SCT and Allo-SCT was 10 months (1-89). Fifty-one patients (96%) received at least one auto-SCT; 24 patients (45%) received a tandem auto-Allo-SCT. At last follow-up, 21 patients (40%) are alive > 5 years post RIC Allo-SCT. At last follow-up, 14 (26%) are in first complete remission (CR), and four patients (8%) in second CR after donor lymphocyte infusion or re-induction with one of the new anti-myeloma drugs (bortezomib or lenalidomide) after Allo-SCT. Eight patients (38%) among these long survivors received one of these new drugs as induction or relapse treatment before Allo-SCT. Disease status and occurrence of cGvHD were significantly associated with progression-free survival (PFS); hazard ratio (HR) = 0.62 (0.30-1.29, P = 0.20). Acute GvHD was correlated with higher transplant-related mortality; HR = 4.19 (1.05-16.77, P = 0.04). No variables were associated with overall survival (OS). In conclusion, we observe that long-term disease control can be expected in a subset of MM patients undergoing RIC Allo-SCT. After 10 years, the OS and PFS were 32% and 24%, respectively. The PFS curve after Allo-SCT stabilizes in time with a plateau after 6 years post Allo-SCT.
authors: Unité de Transplantation et de Thérapie Cellulaire (U2T), Institut Paoli-Calmettes, Marseille, France. elcheikhj@marseille.fnclcc.fr
authors: Jean
authors: J
authors: El-Cheikh
authors: Roberto
authors: R
authors: Crocchiolo
authors: Sabine
authors: S
authors: Furst
authors: Anne-Marie
authors: AM
authors: Stoppa
authors: Patrick
authors: P
authors: Ladaique
authors: Catherine
authors: C
authors: Faucher
authors: Boris
authors: B
authors: Calmels
authors: Claude
authors: C
authors: Lemarie
authors: Jean-Marc Schiano
authors: JM
authors: De Colella
authors: Angela
authors: A
authors: Granata
authors: Diane
authors: D
authors: Coso
authors: Reda
authors: R
authors: Bouabdallah
authors: Christian
authors: C
authors: Chabannon
authors: Didier
authors: D
authors: Blaise
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006086:Graft vs Host Disease / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D035781:Siblings; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous