title: Comparison of upfront tandem autologous-allogeneic transplantation versus reduced intensity allogeneic transplantation for multiple myeloma.
abstract: We performed a retrospective analysis of the European Group for Blood and Marrow Transplantation database comparing the outcomes of multiple myeloma patients who received tandem autologous followed by allogeneic PSCT (auto-allo) with the outcomes of patients who underwent a reduced intensity conditioning allograft (early RIC) without prior autologous transplant. From 1996 to 2013, we identified a total of 690 patients: 517 patients were planned to receive auto-allo and 173 received an early RIC allograft without prior autologous transplant. With a median follow-up of 93 months, 5-year PFS survival was significantly better in the auto-allo group, 34% compared with 22% in the early RIC group (P<0.001). OS was also significantly improved in the auto-allo group with a 5-year rate of 59% vs 42% in the early RIC group (P=0.001). The non-relapse mortality rate was lower in the auto-allo group than in the early RIC group, with 1- and 3-year rates of 8% and 13% vs 20% and 28%, respectively (P<0.001). The relapse/progression rate was similar in the two groups, with 5-year rates of 50% for auto-allo and 46% for early RIC (P=0.42). These data suggest that planned tandem autologous allograft can improve overall survival compared with upfront RIC allograft alone in patients with multiple myeloma.
authors: 1] City of Hope, Duarte, CA, USA [2] Southern California Kaiser Permanente, Los Angeles, CA, USA.
authors: F
authors: F
authors: Sahebi
authors: Università Tor Vergata, Roma, Italy.
authors: S
authors: S
authors: Iacobelli
authors: EBMT, University Medical Center, Leiden, Netherlands.
authors: A V
authors: AV
authors: Biezen
authors: Helsinki University Central Hospital, Helsinki, Finland.
authors: L
authors: L
authors: Volin
authors: University Hospital, Heidelberg, Germany.
authors: P
authors: P
authors: Dreger
authors: Hôpital E. Herriot, Lyon, France.
authors: M
authors: M
authors: Michallet
authors: Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors: P T
authors: PT
authors: Ljungman
authors: Radboud University Medical Centre, Nijmegen, Netherlands.
authors: T
authors: T
authors: de Witte
authors: EBMT, University Medical Center, Leiden, Netherlands.
authors: A
authors: A
authors: Henseler
authors: Radboud University Medical Centre, Nijmegen, Netherlands.
authors: N P M
authors: NP
authors: Schaap
authors: Hospital Universitario, Salamanca, Spain.
authors: L
authors: L
authors: López-Corral
authors: Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors: X
authors: X
authors: Poire
authors: University Hospital, Basel, Switzerland.
authors: J
authors: J
authors: Passweg
authors: Centre Pierre et Marie Curie, Alger, Algeria.
authors: R-M
authors: RM
authors: Hamljadi
authors: City of Hope, Duarte, CA, USA.
authors: S H
authors: SH
authors: Thomas
authors: University Hospital Heidelberg, Heidelberg, Germany.
authors: S
authors: S
authors: Schonland
authors: Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors: G
authors: G
authors: Gahrton
authors: Queens University of Belfast, Belfast, Northern Ireland.
authors: C
authors: C
authors: Morris
authors: University Medical Center, Hamburg, Germany.
authors: N
authors: N
authors: KrÖger
authors: Hôpital Saint Antoine, Paris, France.
authors: L
authors: L
authors: Garderet
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D064592:Autografts; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate