title: Tandem autologous versus autologous/allogeneic transplantation for multiple myeloma: propensity score analysis.
abstract: Autologous hematopoietic stem cell transplantation (auto-HCT) is considered a standard therapy for transplant-eligible patients with multiple myeloma, while allogeneic HCT (allo-HCT) is controversial. We retrospectively analyzed 765 patients with myeloma who underwent tandem transplantation between 1998 and 2012 using Japanese registry data. We evaluated the clinical outcomes of tandem auto-HCT (n = 676) and auto/allo-HCT (n = 89). To adjust for a selection bias, we compared overall survival (OS) between the two groups by a propensity score analysis. The probability of OS at six years was 58.5% for the tandem auto-HCT group and 54.4% for the tandem auto/allo-HCT group (p = 0.47). In a matched-pair analysis based on the propensity score, the difference in survival between the two groups was not statistically significant, although the survival curve appeared to reach a plateau beyond five years in the auto/allo group. Further strategies to reduce treatment-related mortality and enhance a graft-versus-myeloma effect are necessary to improve OS.
authors.affiliation: a Division of Hematology , Saitama Medical Center, Jichi Medical University , Saitama , Japan ;
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: b Division of Hematology and Stem Cell Transplantation , Shizuoka Cancer Center , Shizuoka , Japan ;
authors.forename: Takashi
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: c Division of Hematology, Internal Medicine , National Center for Global Health and Medicine , Tokyo , Japan ;
authors.forename: Shotaro
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: d Department of Medicine, Division of Hematology , Keio University School of Medicine , Tokyo , Japan ;
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.affiliation: e Department of Hematology , Hitachi General Hospital, Hitachi Ltd , Hitachi , Japan ;
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shinagawa
authors.affiliation: f Department of Internal Medicine, Division of Oncology and Hematology , Jikei University School of Medicine, Kashiwa Hospital , Kashiwa , Japan ;
authors.forename: Kaichi
authors.initials: K
authors.lastname: Nishiwaki
authors.affiliation: g Hematology Division , Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital , Tokyo , Japan ;
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: h Department of Hematology , National Hospital Organization Okayama Medical Center , Okayama , Japan ;
authors.forename: Shiro
authors.initials: S
authors.lastname: Kubonishi
authors.affiliation: i Division of Hematopoietic Stem Cell Transplantation , National Cancer Center Hospital , Tokyo , Japan ;
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: j Second Department of Internal Medicine, Division of Hematology , Shinshu University School of Medicine , Matsumoto , Japan ;
authors.forename: Toshiro
authors.initials: T
authors.lastname: Ito
authors.affiliation: k Department of Rheumatology/Hematology/Infectious Disease , Yokohama City University Hospital , Yokohama , Japan ;
authors.forename: Naoto
authors.initials: N
authors.lastname: Tomita
authors.affiliation: l Department of Hematology and Oncology , Research Institute for Radiation Biology and Medicine, Hiroshima University , Hiroshima , Japan ;
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ichinohe
authors.affiliation: m Department of Hematology and Oncology , Children's Medical Center, Japanese Red Cross Nagoya First Hospital , Nagoya , Japan ;
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.affiliation: n Department of Epidemiology and Prevention , Aichi Cancer Center Research Institute , Nagoya , Japan ;
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.affiliation: o Japanese Data Center for Hematopoietic Cell Transplantation , Nagoya, Japan ;|p Department of Healthcare Administration , Nagoya University Graduate School of Medicine , Nagoya , Japan ;
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.affiliation: h Department of Hematology , National Hospital Organization Okayama Medical Center , Okayama , Japan ;
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Sunami
authors.affiliation: a Division of Hematology , Saitama Medical Center, Jichi Medical University , Saitama , Japan ;|q Department of Medicine, Division of Hematology , Jichi Medical University , Shimotsuke , Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D057216:Propensity Score; D019233:Retreatment; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Allogeneic transplantation; multiple myeloma; novel agents; propensity score analysis; tandem autologous transplantation