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Article Dans Une Revue Bone Marrow Transplantation Année : 2021

Second allogeneic transplants for multiple myeloma: a report from the ebmt chronic malignancies working party

Michael Potter
  • Fonction : Auteur
Edouard Forcade
  • Fonction : Auteur
Angelo Michele Carella
  • Fonction : Auteur
Attilio Olivieri
  • Fonction : Auteur

Résumé

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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hal-04428438 , version 1 (14-02-2024)

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Patrick J. Hayden, Dirk-Jan Eikema, Liesbeth C. de Wreede, Linda Koster, Nicolaus Krger, et al.. Second allogeneic transplants for multiple myeloma: a report from the ebmt chronic malignancies working party. Bone Marrow Transplantation, 2021, Bone Marrow Transplantation, ⟨10.1038/s41409-021-01286-x⟩. ⟨hal-04428438⟩
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