Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party

Hayden PJ, Eikema DJ, De Wreede LC, Koster L, Kroger N, Einsele H, Minnema M, Dominietto A, Potter M, Passweg J, Bermudez A, Nguyen-Quoc S, Platzbecker U, Tischer J, Ciceri F, Veelken JH, Ljungman P, Schaap N, Forcade E, Carella AM, Gandemer V, Arcese W, Bloor A, Olivieri A, Vincent L, Beksac M, Schonland S, Yakoub-Agha I (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Book Volume: 56

Pages Range: 2367-2381

Journal Issue: 10

DOI: 10.1038/s41409-021-01286-x

Abstract

The EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30–46%) at 2 years and 25% (17–32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24–46%); Others 9% (0–17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33–67%); Other 22% (8–36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21–40%) vs. 10% (1–20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24–0.67), p < 0.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.

Involved external institutions

St. James's Hospital Ireland (IE) European Society for Blood and Marrow Transplantation EBMT Netherlands (NL) Leiden University Medical Center Netherlands (NL) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Würzburg Germany (DE) University Medical Centre Utrecht (UMC Utrecht) Netherlands (NL) Ospedale San Martino (IRCCS AOU) Italy (IT) Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC) Netherlands (NL) Royal Marsden Hospital / The Royal Marsden NHS Foundation Trust United Kingdom (GB) Universitätsklinikum Heidelberg Germany (DE) Marqués de Valdecilla University Hospital / Hospital Universitario de Marqués de Valdecilla (HUMV) Spain (ES) Pitié-Salpêtrière University Hospital / Hôpital universitaire Pitié-Salpêtrière France (FR) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) Ospedale San Raffaele (früher: Centro San Raffaele del Monte Tabor Foundation) Italy (IT) Karolinska University Hospital / Karolinska Universitetssjukhuset Sweden (SE) Centre Hospitalier Universitaire de Bordeaux / CHU Bordeaux France (FR) Casa Sollievo della Sofferenza Italy (IT) Centre hospitalier universitaire de Rennes / CHU Rennes France (FR) Università degli Studi di Roma 'Tor Vergata' Italy (IT) Christie NHS Foundation Trust United Kingdom (GB) Azienda Ospedaliero Universitaria Ospedali Riuniti Ancona Italy (IT) Hôpital Lapeyronie France (FR) Ankara University / Ankara Üniversitesi Turkey (TR) LILLE 1 University - Science and Technology France (FR)

How to cite

APA:

Hayden, P.J., Eikema, D.-J., De Wreede, L.C., Koster, L., Kroger, N., Einsele, H.,... Yakoub-Agha, I. (2021). Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party. Bone Marrow Transplantation, 56(10), 2367-2381. https://doi.org/10.1038/s41409-021-01286-x

MLA:

Hayden, Patrick J., et al. "Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party." Bone Marrow Transplantation 56.10 (2021): 2367-2381.

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