Allogeneic hematopoietic cell transplantation for multiple myeloma: A retrospective analysis of the Polish Myeloma Group.

Abstract

PURPOSE:

In this multicenter retrospective analysis of the Polish Myeloma Group we assessed the real-life application of allogeneic transplantations (alloHCT) in multiple myeloma (MM) outside clinical trials in Poland.

METHODS:

Anonymized clinical data of patients who underwent alloHCT were retrospectively collected from eight transplant centers and analyzed to identify factors affecting the outcome.

RESULTS:

Sixty patients (34 males, 26 females) at median age of 45 (22-59) years who received alloHCT between 1993 and 2016 were included. In this group, 16 (27%) patients underwent myeloablative conditioning and 44 (73%) reduced-intensity conditioning alloHCT. Acute graft versus host disease (GvHD) occurred in 27 (45%) patients, while chronic GvHD was diagnosed in 13 (22%) patients. With the median observation time after alloHCT of 10 months, the relapse rate was 38%. Median progression-free survival (PFS) reached 9 months (0-183) while median overall survival (OS) was 23 months (0-183). Main causes of death included disease progression in 16 (43%), infections in 10 (27%), and GvHD in 7 patients (19%). Presence of chronic GvHD was the only factor associated with prolonged PFS (28 vs. 6 months; p = 0.05), however its impact on OS was not statistically significant (73 vs. 8 months; p = 0.09).

CONCLUSIONS:

In this relatively small and heterogeneous study we observed that alloHCT was associated with high risk of severe complications, but resulted in long-term survival in a proportion of patients. Decisions on optimal indications and timing of the alloHCT in MM need to be taken in the broader context of reported outcomes including data from large studies.

• Authors: Aleksandra Gołos, Lidia Gil, Bartosz Puła, Piotr Boguradzki, Kazimierz Hałaburda, Waldemar Sawicki, Małgorzata Sobczyk-Kruszelnicka, Grzegorz Helbig, Jarosław Dybko, Artur Jurczyszyn, Sonia Dębek, Krzysztof Warzocha, Krzysztof Jamroziak
• Journal: Advances in medical sciences (Adv Med Sci) Vol. 65 Issue 2 Pg. 429-436 (Sep 2020) ISSN: 1898-4002 [Electronic] Netherlands
• PMID: 32919120 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

Topics

• Adult
• Female
• Follow-Up Studies
• Graft vs Host Disease (mortality, prevention & control)
• Hematopoietic Stem Cell Transplantation (mortality)
• Humans
• Male
• Middle Aged
• Multiple Myeloma (pathology, therapy)
• Poland
• Prognosis
• Retrospective Studies
• Survival Rate
• Transplantation Conditioning
• Transplantation, Homologous