Conditioning-based outcomes after allogeneic transplantation for myeloma following a prior autologous transplant (1991-2012) on behalf of EBMT CMWP

Patrick J. Hayden, Simona Iacobelli, José Antonio Pérez-Simón, Anja van Biezen, Monique Minnema, Riitta Niittyvuopio, Stefan Schönland, Ellen Meijer, Didier Blaise, Noel Milpied, Francisco J. Márquez-Malaver, Joan Hendrik Veelken, Johan Maertens, Mauricette Michallet, J. rg Cammenga, Stephanie N'Guyen, Dietger Niederwieser, Mathilde Hunault-Berger, Jean Henri Bourhis, Jakob PasswegArancha Bermudez, Yves Chalandon, Ibrahim Yakoub-Agha, Laurent Garderet, Nicolaus Kröger

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives: The aim of this study was to compare the effect of the intensity of conditioning approaches used in allogeneic transplantation in myeloma—reduced intensity conditioning (RIC), non-myeloablative (NMA), myeloablative conditioning (MAC) or Auto-AlloHCT—on outcomes in patients who had had a prior autologous transplant. Methods: A retrospective analysis of the EBMT database (1991-2012) was performed. Results: A total of 344 patients aged between 40 and 60 years at the time of alloHCT were identified: 169 RIC, 69 NMA, 65 MAC and 41 Auto-Allo transplants. At a median follow-up of 54 months, the probabilities of overall survival (OS) at 5 years were 39% (95% CI 31%-47%), 45% (95% CI 32%-57%), 19% (95% CI 6%-32%) and 34% (95% CI 17%-51%), respectively. Status at allogeneic HCT other than CR or PR conferred a 70% higher risk of death and a 40% higher risk of relapse. OS was markedly lower in the MAC group (P =.004). MAC alloHCT was associated with a higher risk of death than RIC alloHCT until 2002 (HR = 4.1, P <.001) but not after 2002 (HR = 1.2, P =.276). Conclusion: From 1991 to 2002, MAC was associated with poorer OS. Between 2003 and 2012, there were no significant differences in outcomes based on these different approaches.
Original languageEnglish
Pages (from-to)181-189
Number of pages9
JournalEuropean Journal of Haematology
Volume104
Issue number3
Early online date18 Nov 2019
DOIs
Publication statusPublished - 1 Mar 2020

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