Abstract |
We report results of a retrospective analysis of 44 patients with relapsed and high-risk multiple myeloma (MM) undergoing allogeneic CD34-selected hematopoietic stem cell transplantation (HSCT) from HLA-compatible donors. Patients had multiply relapsed disease including relapse at <15 months after autologous transplantation and most patients (28 of 44; 65%) also had high-risk cytogenetics. Before transplantation, patients received busulfan (.8 mg/kg × 10 doses), melphalan (70 mg/m(2) × 2 days), fludarabine (25 mg/m(2) × 5 days), and rabbit antithymocyte globulin (2.5 mg/kg × 2 days). Patients with 10/10 HLA- matched donors were treated prophylactically with low doses of donor lymphocyte infusions (.5 to 1 × 10(6) CD3(+)/kg) starting 4 to 6 months after CD34-selected HSCT. Acute (grade II to IV) graft-versus-host disease (GVHD) and transplantation-related mortality at 12 months were 2% and 18%, respectively. Chronic GVHD was not observed in any patient. Overall and progression-free survival at 2 years were 54% and 31%, respectively. By multivariate analyses, the outcomes of CD34-selected HSCT were influenced by presence of extramedullary disease, disease status before CD34-selected HSCT, and age. This study demonstrates notable safety and efficacy of CD34-selected HSCT in patients with multiply relapsed MM, including those with high-risk cytogenetics.
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Authors | Eric Smith, Sean M Devlin, Satyajit Kosuri, Evelyn Orlando, Heather Landau, Alex M Lesokhin, David J Chung, Hani Hassoun, Nikoletta Lendvai, Ola Landgren, Sergio Giralt, Ajai Chari, Sundar Jagannath, Guenther Koehne |
Journal | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
(Biol Blood Marrow Transplant)
Vol. 22
Issue 2
Pg. 258-267
(Feb 2016)
ISSN: 1523-6536 [Electronic] United States |
PMID | 26325439
(Publication Type: Journal Article)
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Copyright | Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Aged
- Antigens, CD34
(metabolism)
- Disease-Free Survival
- Female
- Hematopoietic Stem Cell Transplantation
(methods)
- Humans
- Immunotherapy, Adoptive
(methods)
- Male
- Middle Aged
- Multiple Myeloma
(mortality, therapy)
- Risk Factors
- Transplantation Conditioning
(methods)
- Transplantation, Homologous
(methods)
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