Outcomes of haploidentical transplantation in patients with relapsed multiple myeloma

• Verfasst von: Sahebi, Firoozeh [VerfasserIn]
• Verfasst von: Dreger, Peter [VerfasserIn]
• Verfasst von: Schönland, Stefan [VerfasserIn]
• Titel: Outcomes of haploidentical transplantation in patients with relapsed multiple myeloma
• Titelzusatz: An EBMT/CIBMTR report
• Verf.angabe: Firoozeh Sahebi, Laurent Garderet, Abraham S. Kanate, Diderik-Jan Eikema, Nina Simone Knelange, Omar F. Dávila Alvelo, Yener Koc, Didier Blaise, Qaiser Bashir, José M. Moraleda, Peter Dreger, James F. Sanchez, Stefan Ciurea, Harry Schouten, Nirav N. Shah, Mareike Verbeek, Wolf Rösler, Jose L. Diez-Martin, Stefan Schoenland, Anita D'Souza, Nicolaus Kröger, Parameswaran Hari
• Jahr des Originals: 2018
• Umfang: 8 S.
• Fussnoten: Available online 20 September 2018 ; Gesehen am 27.02.2019
• Titel Quelle: Enthalten in: Biology of blood and marrow transplantation
• Jahr Quelle: 2019
• Band/Heft Quelle: 25(2019), 2, S. 335-342
• ISSN Quelle: 1523-6536
• DOI: doi:10.1016/j.bbmt.2018.09.018
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1588177823

Abstract

Allogeneic hematopoietic cell transplantation (allo-HCT) using siblings and matched donors has the potential for long-term disease control in a subset of high-risk patients with multiple myeloma (MM); however, the data on using haploidentical donors in this disease are limited. We conducted a retrospective analysis to examine the outcomes of patients with MM who underwent haploidentical allo-HCT within European Society for Blood and Marrow Transplantation/Center for International Blood and Marrow Transplant Research centers. A total of 96 patients underwent haploidentical allo-HCT between 2008 and 2016. With a median follow-up of 24.0 months (range, 13.2 to 24.9 months), 97% (95% confidence interval [CI], 93% to 100%) of patients had neutrophil engraftment by day 28, and 75% (95% CI, 66% to 84%) achieved platelet recovery by day 60. Two-year progression-free survival (PFS) was 17% (95% CI, 8% to 26%), and overall survival (OS) was 48% (95% CI, 36% to 59%). At 2 years, the cumulative risk of relapse/progression was 56% (95% CI, 45% to 67%), and 1-year nonrelapse mortality (NRM) was 21% (95% CI, 13% to 29%). The incidences of acute graft-versus-host-disease (GVHD) grades II-IV by 100 days and chronic GVHD at 2 years were 39% (95% CI, 28% to 49%) and 46% (95% CI, 34% to 59%), respectively. On univariate analysis, use of post-transplantation cyclophosphamide (PT-Cy) (54% [95% CI, 41% to 68%] versus 25% [95% CI, 1% to 48%]; P =.009) and use of bone marrow as source of stem cells (72% [95% CI, 55% to 89%] versus 31% [95% CI, 17% to 46%]; P=.001) were associated with improved OS at 2 years. Disease status, patient sex, intensity of conditioning regimen, recipient/donor sex mismatch, and cytomegalovirus serostatus had no impact on OS, PFS, or NRM. Haploidentical transplantation is feasible for patients with multiply relapsed or high-risk MM, with an encouraging 2-year OS of 48% and an NRM of 21% at 1 year, supporting further investigation of haploidentical allo-HCT in suitable candidates with MM.