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Hayden, Patrick J.; Eikema, Dirk-Jan; de Wreede, Liesbeth C.; Koster, Linda; Kroger, Nicolaus; Einsele, Hermann; Minnema, Monique; Dominietto, Alida; Potter, Michael; Passweg, Jacob; Bermudez, Arancha; Nguyen-quoc, Stephanie; Platzbecker, Uwe; Tischer, Johanna; Ciceri, Fabio; Veelken, Joan Hendrik; Ljungman, Per; Schaap, Nicolaas; Forcade, Edouard; Carella, Angelo Michele; Gandemer, Virginie; Arcese, William; Bloor, Adrian; Olivieri, Attilio; Vincent, Laure; Beksac, Meral; Schonland, Stefan und Yakoub-Agha, Ibrahim (2021): Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party. In: Bone Marrow Transplantation, Bd. 56, Nr. 10: S. 2367-2381

Volltext auf 'Open Access LMU' nicht verfügbar.

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.

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