Allogeneic hematopoietic cell transplantation for multiple myeloma in Europe: trends and outcomes over 25 years. A study by the EBMT Chronic Malignancies Working Party.
We describe the use and outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for multiple myeloma (MM) in Europe between January 1990 and December 2012. We identified 7333 patients, median age at allo-HSCT was 51 years (range: 18-78), of whom 4539 (62%) were males. We distinguished three groups: (1) allo-HSCT upfront (n=1924), (2) tandem auto-allo-HSCT (n=2004) and (3) allo-HSCT as a second line treatment and beyond (n=3405). Overall, there is a steady increase in numbers of allo-HSCT over the years. Upfront allo-HSCT use increased up to year 2000, followed by a decrease thereafter and represented 12% of allo-HSCTs performed in 2012. Tandem auto-allo-HSCT peaked around year 2004 and contributed to 19% of allo-HSCTs in 2012. Allo-HSCT as salvage after one or two or three autografts was steadily increasing over the last years and represented 69% of allo-HSCTs in 2012. Remarkable heterogeneity in using allo-HSCT was observed among the different European countries. The 5-year survival probabilities from time of allo-HSCT for the three groups after year 2004 were 42%, 54% and 32%, respectively. These results show that the use of allo-HSCT is increasing in Europe, especially as second line treatment and beyond. There is an unmet need for well-designed prospective studies investigating allo-HSCT as salvage therapy for MM.
Hematology Department, Centre Hospitalier Lyon Sud, Pierre Bénite, France.
M
M
Sobh
Hematology Department, Centre Hospitalier Lyon Sud, Pierre Bénite, France.
M
M
Michallet
Hematology Department, Karolinska Institutet, Stockholm, Sweden.
G
G
Gahrton
Centro Interdipartimentale di Biostatistica e Bioinformatica, Università Tor Vergata, Rome, Italy.
S
S
Iacobelli
EBMT Data Office, Leiden, The Netherlands.
A
A
van Biezen
Hematology Department, University of Heidelberg, Heidelberg, Germany.
S
S
Schönland
Hematology Department, University Medical Center, Utrecht, The Netherlands.
E
E
Petersen
Hematology department, Radboud University-Nijmegen Medical Center, The Netherlands.
N
N
Schaap
Hematology Department, Bologna University, S.Orsola-Malpighi Hospital, Bologna, Italy.
F
F
Bonifazi
Hematology Department, Helsinki University Central Hospital, Helsinki, Finland.
L
L
Volin
Hematology Department, VU University Medical Center, Amsterdam, The Netherlands.
E
E
Meijer
Hematology Department, University Hospital Leipzig, Leipzig, Germany.
D
D
Niederwieser
Hematology Department, Institut Paoli Calmettes, Marseille, France.
J
J
El Cheikh
Hematology Department, Hôpital Haut-leveque, Pessac, France.
R
R
Tabrizi
Hematology Department, CHU Lapeyronie, Montpellier, France.
N
N
Fegeux
Hematology Department, University of Freiburg, Freiburg, Germany.
J
J
Finke
Hematology Department, Universitätsklinikum Ulm, Ulm, Germany.
D
D
Bunjes
Hematology Department, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
J
J
Cornelissen
Hematology Department, Universitätsklinikum Würzburg, Würzburg, Germany.
H
H
Einsele
Hematology Department, Presidio Molinette, Torino, Italy.
B
B
Bruno
Hematology Department, Royal Marsden Hospital, London, UK.
M
M
Potter
Hematology Department, Azienda Ospedaliero Universitaria di Udine, Udine, Italy.
R
R
Fanin
Hematology Department, Hospital Saint Antoine, Paris, France.
M
M
Mohty
Hematology Department, Hospital Saint Antoine, Paris, France.
L
L
Garderet
Hematology Department, University Hospital Eppendorf, Hamburg, Germany.
N
N
Kröger
D000293:Adolescent; D000328:Adult; D000368:Aged; D005060:Europe; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult