The use of allo-SCT is limited by transplant-related mortality (TRM) that can rise to 41% with myeloablative conditioning (MAC). Our results indicate that auto-allo-SCT is feasible and could be considered for younger patients in the upfront setting.Īllogeneic stem cell transplantation (allo-SCT) is thus far the only potentially curative treatment approach in multiple myeloma (MM), but only a fraction of patients are eligible for it. Allo-SCT resulted in long-term survival in a small subgroup of patients.
In multivariate analysis, the auto-allo group had improved OS and chronic graft-versus-host disease was advantageous in terms of PFS, OS, and relapse incidence.
Survival of high-risk patients was reduced. Post-relapse survival was 4.1 years for upfront-allo and auto-allo, and 2.6 years for the relapse group ( p = 0.066). Non-relapse mortality at 5 years was 8% overall, with no significant difference between the groups. Progression-free survival (PFS) was 2.4, 2.4, and 0.9 years, respectively ( p < 0.001). Median overall survival (OS) was 9.9 years for upfront-allo, 11.2 years for auto-allo, and 3.9 years for the relapse group ( p = 0.015). Transplantation was performed on 75 patients without a previous autologous SCT (upfront-allo), on 74 as tandem transplant (auto-allo), and on 56 patients after relapse.
We analyzed the results of 205 patients transplanted in one center during 2000–2017. The role of allogeneic hematopoietic stem cell transplantation (allo-SCT) in multiple myeloma is controversial.
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