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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.
AuthorsKoji Kawamura, Takashi Ikeda, Shotaro Hagiwara, Takehiko Mori, Atsushi Shinagawa, Kaichi Nishiwaki, Kazuteru Ohashi, Shiro Kubonishi, Takahiro Fukuda, Toshiro Ito, Naoto Tomita, Tatsuo Ichinohe, Koji Kato, Yasuo Morishima, Yoshiko Atsuta, Kazutaka Sunami, Yoshinobu Kanda
JournalLeukemia & lymphoma (Leuk Lymphoma) Vol. 57 Issue 9 Pg. 2077-83 (09 2016) ISSN: 1029-2403 [Electronic] United States
PMID26961137 (Publication Type: Journal Article)
Chemical References
  • Biomarkers
Topics
  • Adult
  • Aged
  • Biomarkers
  • Female
  • Hematopoietic Stem Cell Transplantation (adverse effects, methods)
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multiple Myeloma (diagnosis, mortality, therapy)
  • Neoplasm Staging
  • Prognosis
  • Propensity Score
  • Retreatment
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

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