Details

Autor(en) / Beteiligte

• MOHTY, M
• BOIRON, J. M
• TABRIZI, R
• GASTAUT, J. A
• MICHALLET, M
• MARANINCHI, D
• BLAISE, D
• DAMAJ, G
• MICHALLET, A. S
• BAY, J. O
• FAUCHER, C
• PERREAU, V
• BILGER, K
• COSO, D
• STOPPA, A. M

Titel

Graft-versus-myeloma effect following antithymocyte globulin-based reduced intensity conditioning allogeneic stem cell transplantation

Ist Teil von

• Bone marrow transplantation (Basingstoke), 2004-07, Vol.34 (1), p.77-84

Ort / Verlag

Basingstoke: Nature Publishing Group

Erscheinungsjahr

2004

Quelle

MEDLINE

Beschreibungen/Notizen

• In all, 41 multiple myeloma (MM) patients received an antithymocyte globulin (ATG), fludarabine, and busulfan-based reduced intensity conditioning (RIC) for allogeneic stem cell transplantation (allo-SCT) from HLA-identical siblings. In total, 29 patients (70%) were in partial remission, one patient in complete remission, and 11 (27%) with progressive disease at the time of allo-SCT. Median time between diagnosis and allo-SCT was 24 months. The cumulative incidences of grade II-IV and grade III-IV acute graft-versus-host disease (GVHD) were 36% (95% CI, 21-51%) and 7% (95% CI, 2-20%), respectively. Overall, 10 patients developed limited chronic GVHD, whereas seven developed an extensive form (cumulative incidence, 41% (95% CI, 26-56%) at 2 years). With a median follow-up of 389 days, the overall cumulative incidence of transplant-related mortality (TRM) was 17% (95% CI, 6-28%). In all, 11 patients (27%) are in continuous complete remission, and the Kaplan-Meier estimates of overall survival (OS) and progression-free survival (PFS) at 2 years were 62% (95% CI, 47-76%) and 41% (95% CI, 23-62%), respectively. PFS and OS were significantly higher in patients with chronic GVHD as compared to patients without chronic GVHD (P=0.006 for PFS and P=0.01 for OS). Collectively, these data demonstrate that RIC allo-SCT can mediate a potentially curative graft-versus-myeloma effect with an acceptable incidence of toxicity and TRM.