Allogeneic transplantation in multiple myeloma: long-term follow-up and cytogenetic subgroup analysis

Knop, Stefan; Engelhardt, Monika; Liebisch, Peter; Meisner, Christoph; Holler, Ernst; Metzner, Bernd; Peest, Dietrich; Kaufmann, Martin; Bunjes, Donald; Straka, Christian; Fischer, Thomas; Sezer, Orhan; Hentrich, Marcus; Ostermann, Helmut; Bassermann, Florian; Hess, Georg; Hertenstein, Bernd; Freund, Mathias; Kropff, Martin; Schmidt, Christian A.; Wolf, Hans-Heinrich; Jung, Wolfram; Frickhofen, Norbert; Mielke, Stephan; Bargou, Ralf C.; Maschmeyer, Georg; Svaldi, Mirija; Langer, Christian H.; Gramatzki, Martin; Hebart, Holger; Kanz, Lothar; Einsele, Hermann; Sezer, O.; Doerken, B.; Gerecke, C.; Fuhrmann, S.; Ludwig, W. D.; Hertenstein, B.; Bormann, M.; Meyer, R.; Naumann, R.; Platzbecker, U.; Roellig, Ch; Roesler, W.; Metzler, I. von; Martin, H.; Engelhardt, M.; Finke, J.; Truemper, L.; Jung, W.; Schmidt, Ch A.; Doelken, G.; Wolf, H. H.; Müller, L.; Ligeti, K.; Kröger, N.; Schilling, G.; Duerk, H.; Peest, D.; Ganser, A.; Pfreundschuh, M.; Sayer, H.; Lilienfeld-Toal, M. von; Muegge, L. O.; Bentz, M.; Gramatzki, M.; Brueggemann, M.; Fischer, T.; Wolleschak, D.; Hess, G.; Kropff, M.; Reusch, J.; Straka, C.; Ostermann, H.; Franke, D.; Peschel, C.; Dechow, T.; Bassermann, F.; Hentrich, M.; Wandt, H.; Schäfer-Eckart, K.; Metzner, B.; Maschmeyer, G.; Holler, E.; Hart, C.; Reichle, A.; Freund, M.; Böttcher, S.; Kahl, C.; Mergenthaler, H. G.; Aulitzky, W.; Kaufmann, M.; Greiner, J.; Heidemann, E.; Kanz, L.; Hebart, H.; Liebisch, P.; Bunjes, D.; Langer, C.; Frickhofen, N.; Einsele, H.; Knop, S.; Mielke, S.; Bargou, R. C. und Svaldi, M. (2019): Allogeneic transplantation in multiple myeloma: long-term follow-up and cytogenetic subgroup analysis. In: Leukemia, Bd. 33, Nr. 11: S. 2710-2719

Abstract

This phase 3 trial compared tandem autologous stem cell transplantation (autoSCT) versus autoSCT followed by reduced-intensity conditioning allogeneic stem cell transplantation (auto/alloSCT) in patients with newly diagnosed multiple myeloma (MM) with deletion of (del) chromosome 13q (del13q). The availability/absence of a human leukocyte antigen-matched-related or matched-unrelated donor (MUD) determined the nature of the second SCT. The primary endpoint was progression-free survival (PFS) in the intention-to-treat population (n = 199). Auto/alloSCT was performed in 126 patients;74 received MUD allografts. After 91 months median follow-up, median PFS with auto/allo versus tandem autoSCT was 34.5 versus 21.8 months (P = 0.003;adjusted hazard ratio 0.55, 95% confidence interval 0.36-0.84). Median overall survival (OS) was 70.2 versus 71.8 months (P = 0.856). Two-year non-relapse mortality with auto/allo versus tandem autoSCT was 14.3% versus 4.1% (P = 0.008). In patients harboring both del13q and del17p, median PFS and OS were 37.5 and 61.5 months with auto/allo (n = 19) versus 6.1 and 23.4 months with tandem autoSCT (n = 6) (P = 0.0002 and 0.032). Our findings suggest that auto/alloSCT significantly extends PFS versus tandem autoSCT in del13q MM, and indicate some survival benefit for first-line alloSCT in high-risk MM.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0887-6924
• Sprache: Englisch