Autologous/Allogeneic Hematopoietic Cell Transplantation versus Tandem Autologous Transplantation for Multiple Myeloma: Comparison of Long-Term Postrelapse Survival
dc.contributor.author | Htut, Myo | |
dc.contributor.author | Ramanathan, Muthalagu | |
dc.contributor.author | Hari, Parameswaran | |
dc.date | 2022-08-11T08:09:49.000 | |
dc.date.accessioned | 2022-08-23T16:44:57Z | |
dc.date.available | 2022-08-23T16:44:57Z | |
dc.date.issued | 2018-03-01 | |
dc.date.submitted | 2018-05-30 | |
dc.identifier.citation | <p>Biol Blood Marrow Transplant. 2018 Mar;24(3):478-485. doi: 10.1016/j.bbmt.2017.10.024. Epub 2017 Oct 24. <a href="https://doi.org/10.1016/j.bbmt.2017.10.024">Link to article on publisher's site</a></p> | |
dc.identifier.issn | 1083-8791 (Linking) | |
dc.identifier.doi | 10.1016/j.bbmt.2017.10.024 | |
dc.identifier.pmid | 29079457 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/40600 | |
dc.description | <p>Full author list omitted for brevity. For the full list of authors, see article.</p> | |
dc.description.abstract | We compared postrelapse overall survival (OS) after autologous/allogeneic (auto/allo) versus tandem autologous (auto/auto) hematopoietic cell transplantation (HCT) in patients with multiple myeloma (MM). Postrelapse survival of patients receiving an auto/auto or auto/allo HCT for MM and prospectively reported to the Center for International Blood and Marrow Transplant Research between 2000 and 2010 were analyzed. Relapse occurred in 404 patients (72.4%) in the auto/auto group and in 178 patients (67.4%) in the auto/allo group after a median follow-up of 8.5 years. Relapse occurred before 6 months after a second HCT in 46% of the auto/allo patients, compared with 26% of the auto/auto patients. The 6-year postrelapse survival was better in the auto/allo group compared with the auto/auto group (44% versus 35%; P = .05). Mortality due to MM was 69% (n = 101) in the auto/allo group and 83% (n = 229) deaths in auto/auto group. In multivariate analysis, both cohorts had a similar risk of death in the first year after relapse (hazard ratio [HR], .72; P = .12); however, for time points beyond 12 months after relapse, overall survival was superior in the auto/allo cohort (HR for death in auto/auto =1.55; P = .005). Other factors associated with superior survival were enrollment in a clinical trial for HCT, male sex, and use of novel agents at induction before HCT. Our findings shown superior survival afterrelapse in auto/allo HCT recipients compared with auto/auto HCT recipients. This likely reflects a better response to salvage therapy, such as immunomodulatory drugs, potentiated by a donor-derived immunologic milieu. Further augmentation of the post-allo-HCT immune system with new immunotherapies, such as monoclonal antibodies, checkpoint inhibitors, and others, merit investigation. | |
dc.language.iso | en_US | |
dc.relation | <p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29079457&dopt=Abstract">Link to Article in PubMed</a></p> | |
dc.rights | Author's submitted manuscript (preprint) posted as allowed by publisher's article sharing policy at: https://www.elsevier.com/about/our-business/policies/sharing. | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject | Allogeneic transplantation | |
dc.subject | Myeloma | |
dc.subject | Relapse | |
dc.subject | Survival | |
dc.subject | Hematology | |
dc.subject | Hemic and Immune Systems | |
dc.subject | Hemic and Lymphatic Diseases | |
dc.subject | Neoplasms | |
dc.subject | Oncology | |
dc.title | Autologous/Allogeneic Hematopoietic Cell Transplantation versus Tandem Autologous Transplantation for Multiple Myeloma: Comparison of Long-Term Postrelapse Survival | |
dc.type | Preprint | |
dc.source.journaltitle | Biology of Blood and Marrow Transplantation | |
dc.source.volume | 24 | |
dc.source.issue | 3 | |
dc.identifier.legacyfulltext | https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=4415&context=oapubs&unstamped=1 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/oapubs/3404 | |
dc.identifier.contextkey | 12222285 | |
refterms.dateFOA | 2022-08-23T16:44:58Z | |
html.description.abstract | <p>We compared postrelapse overall survival (OS) after autologous/allogeneic (auto/allo) versus tandem autologous (auto/auto) hematopoietic cell transplantation (HCT) in patients with multiple myeloma (MM). Postrelapse survival of patients receiving an auto/auto or auto/allo HCT for MM and prospectively reported to the Center for International Blood and Marrow Transplant Research between 2000 and 2010 were analyzed. Relapse occurred in 404 patients (72.4%) in the auto/auto group and in 178 patients (67.4%) in the auto/allo group after a median follow-up of 8.5 years. Relapse occurred before 6 months after a second HCT in 46% of the auto/allo patients, compared with 26% of the auto/auto patients. The 6-year postrelapse survival was better in the auto/allo group compared with the auto/auto group (44% versus 35%; P = .05). Mortality due to MM was 69% (n = 101) in the auto/allo group and 83% (n = 229) deaths in auto/auto group. In multivariate analysis, both cohorts had a similar risk of death in the first year after relapse (hazard ratio [HR], .72; P = .12); however, for time points beyond 12 months after relapse, overall survival was superior in the auto/allo cohort (HR for death in auto/auto =1.55; P = .005). Other factors associated with superior survival were enrollment in a clinical trial for HCT, male sex, and use of novel agents at induction before HCT. Our findings shown superior survival afterrelapse in auto/allo HCT recipients compared with auto/auto HCT recipients. This likely reflects a better response to salvage therapy, such as immunomodulatory drugs, potentiated by a donor-derived immunologic milieu. Further augmentation of the post-allo-HCT immune system with new immunotherapies, such as monoclonal antibodies, checkpoint inhibitors, and others, merit investigation.</p> | |
dc.identifier.submissionpath | oapubs/3404 | |
dc.contributor.department | Division of Hematology and Oncology, Department of Medicine | |
dc.source.pages | 478-485 |