title: Allogeneic hematopoietic cell transplantation from unrelated donors in multiple myeloma: study from the Italian Bone Marrow Donor Registry.
abstract: To evaluate trends in allografting from unrelated donors, we conducted a study on 196 consecutive myeloma patients transplanted between 2000 and 2009 in Italy. Twenty-eight percent, 37%, and 35%, respectively, received myeloablative, reduced-intensity, and nonmyeloablative conditioning. In these 3 cohorts, 1-year and 5-year transplantation-related mortalities were 28.8% and 37.0%, 20.3% and 31.3%, and 25.0% and 30.3%, respectively (P = .745). Median overall survival (OS) and event-free survival from transplantation for the 3 cohorts were 29 and 10 months, 11 and 6 months, and 32 and 13 months, respectively (P = .039 and P = .049). Overall cumulative incidences of acute and chronic graft-versus-host-disease (GVHD) were 46.1% and 51.1%. By Cox multivariate analyses, chronic GVHD was significantly associated with longer OS (hazard ratio [HR], .51; P = .009), whereas the use of peripheral blood stem cells was borderline significant (HR, .55; P = .051). Better response posttransplantation was associated with longer event-free survival (HR, 2.13 to 4.25; P < .001). Acute GVHD was associated with poorer OS (HR, 2.53; P = .001). This analysis showed a strong association of acute and chronic GVHD and depth of response posttransplantation with clinical outcomes. Long-term disease control remains challenging regardless of the conditioning. In the light of these results, prospective trials may be designed to better define the role of allografting from unrelated donors in myeloma.
authors.affiliation: Divison of Nuclear Medicine 2, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.forename: Simona
authors.initials: S
authors.lastname: Pollichieni
authors.forename: Lucia
authors.initials: L
authors.lastname: Brunello
authors.forename: Francesca
authors.initials: F
authors.lastname: Patriarca
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonifazi
authors.forename: Vittorio
authors.initials: V
authors.lastname: Montefusco
authors.forename: Michele
authors.initials: M
authors.lastname: Falda
authors.forename: Mauro
authors.initials: M
authors.lastname: Montanari
authors.forename: Stefano
authors.initials: S
authors.lastname: Guidi
authors.forename: Luisa
authors.initials: L
authors.lastname: Giaccone
authors.forename: Nicola
authors.initials: N
authors.lastname: Mordini
authors.forename: Angelo Michele
authors.initials: AM
authors.lastname: Carella
authors.forename: Pasqua
authors.initials: P
authors.lastname: Bavaro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Milone
authors.forename: Fabio
authors.initials: F
authors.lastname: Benedetti
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.forename: Rosanna
authors.initials: R
authors.lastname: Scimè
authors.forename: Edoardo
authors.initials: E
authors.lastname: Benedetti
authors.forename: Luca
authors.initials: L
authors.lastname: Castagna
authors.forename: Moreno
authors.initials: M
authors.lastname: Festuccia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.forename: Andrea
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bandini
authors.forename: Renato
authors.initials: R
authors.lastname: Fanin
authors.forename: Benedetto
authors.initials: B
authors.lastname: Bruno
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D061349:Unrelated Donors
chemical_list: D019653:Myeloablative Agonists