Long-term outcome after allogeneic stem cell transplantation in multiple myeloma

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http://hdl.handle.net/10138/330970

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Luoma , S , Silvennoinen , R , Rauhala , A , Niittyvuopio , R , Martelin , E , Lindström , V , Heiskanen , J , Volin , L , Ruutu , T & Nihtinen , A 2021 , ' Long-term outcome after allogeneic stem cell transplantation in multiple myeloma ' , Annals of Hematology , vol. 100 , no. 6 , pp. 1553-1567 . https://doi.org/10.1007/s00277-021-04514-y

Title: Long-term outcome after allogeneic stem cell transplantation in multiple myeloma
Author: Luoma, Sini; Silvennoinen, Raija; Rauhala, Auvo; Niittyvuopio, Riitta; Martelin, Eeva; Lindström, Vesa; Heiskanen, Jouni; Volin, Liisa; Ruutu, Tapani; Nihtinen, Anne
Contributor organization: Hematologian yksikkö
HUS Comprehensive Cancer Center
Department of Oncology
University of Helsinki
Helsinki University Hospital Area
HUS Head and Neck Center
Clinicum
Date: 2021-06
Language: eng
Number of pages: 15
Belongs to series: Annals of Hematology
ISSN: 0939-5555
DOI: https://doi.org/10.1007/s00277-021-04514-y
URI: http://hdl.handle.net/10138/330970
Abstract: The role of allogeneic hematopoietic stem cell transplantation (allo-SCT) in multiple myeloma is controversial. We analyzed the results of 205 patients transplanted in one center during 2000-2017. Transplantation was performed on 75 patients without a previous autologous SCT (upfront-allo), on 74 as tandem transplant (auto-allo), and on 56 patients after relapse. Median overall survival (OS) was 9.9 years for upfront-allo, 11.2 years for auto-allo, and 3.9 years for the relapse group (p = 0.015). Progression-free survival (PFS) was 2.4, 2.4, and 0.9 years, respectively (p < 0.001). Non-relapse mortality at 5 years was 8% overall, with no significant difference between the groups. Post-relapse survival was 4.1 years for upfront-allo and auto-allo, and 2.6 years for the relapse group (p = 0.066). Survival of high-risk patients was reduced. In multivariate analysis, the auto-allo group had improved OS and chronic graft-versus-host disease was advantageous in terms of PFS, OS, and relapse incidence. Late relapses occurred in all groups. Allo-SCT resulted in long-term survival in a small subgroup of patients. Our results indicate that auto-allo-SCT is feasible and could be considered for younger patients in the upfront setting.
Subject: Multiple myeloma
Allogeneic stem cell transplantation
Survival
Conditioning
Graft-versus-host disease
Post-relapse survival
3122 Cancers
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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