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Outcome of allogeneic transplantation in newly diagnosed and relapsed/refractory multiple myeloma: long‐term follow‐up in a single institution
Author(s) -
Franssen Laurens E.,
Raymakers Reinier A. P.,
Buijs Arjan,
Schmitz Marian F.,
Dorp Suzanne,
Mutis Tuna,
Lokhorst Henk M.,
Donk Niels W. C. J.
Publication year - 2016
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12758
Subject(s) - medicine , refractory (planetary science) , transplantation , multiple myeloma , surgery , oncology , astrobiology , physics
Allogeneic stem cell transplantation (allo‐ SCT ) has the potential to induce long‐term remission in multiple myeloma ( MM ), but the role of allo‐ SCT in MM is controversial due to the high rate of treatment‐related mortality ( TRM ). However, although proteasome inhibitors and immunomodulatory drugs have improved the outcome of patients with MM , high‐risk patients still have a very poor prognosis. This indicates the need for new treatment strategies and identification of patients who might benefit from allo‐ SCT . We therefore analyzed the outcome of one hundred and forty‐seven patients with MM who received an allo‐ SCT at our institution (58 in first line, 89 in relapsed/refractory setting) after a median follow‐up of 88.8 months. For the first‐line setting, median progression‐free survival ( PFS ) and overall survival ( OS ) were remarkably good, with a CR rate of 48.3%, median PFS of 30.2 months, and 10‐yr OS of 51%. We found no difference in outcome for patients with high‐risk metaphase cytogenetics or FISH del(13q14), but efficacy in current standard high‐risk patients could not be determined. The outcome in the relapsed/refractory setting was poor, especially in the subgroup of patients relapsing within 18 months after auto‐ SCT . Therefore, if applied at all in these patients, improvement of allo‐ SCT is needed, focusing on reduction of TRM and more effective immunotherapy.