Outcomes of Haploidentical Transplantation in Patients with Relapsed Multiple Myeloma: An EBMT/CIBMTR Report

Sahebi F, Garderet L, Kanate AS, Eikema DJ, Knelange NS, Alvelo OF, Koc Y, Blaise D, Bashir Q, Moraleda JM, Dreger P, Sanchez JF, Ciurea S, Schouten H, Shah NN, Verbeek M, Rösler W, Diez-Martin JL, Schoenland S, D'Souza A, Kröger N, Hari P (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Biology of Blood and Marrow Transplantation Elsevier

DOI: 10.1016/j.bbmt.2018.09.018

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.

Authors with CRIS profile

Wolf Rösler Department of Medicine 5 – Haematology and Oncology

Involved external institutions

Medical College of Wisconsin (MCW) US United States (USA) (US) CRCM Centre de Recherche en Cancérologie de Marseille FR France (FR) CIBMTR (Center for International Blood and Marrow Transplant Research) US United States (USA) (US) Klinikum rechts der Isar DE Germany (DE) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Maastricht University NL Netherlands (NL) Hospital Clínico Universitario Virgen de la Arrixaca ES Spain (ES) Hospital General Universitario Gregorio Marañón ES Spain (ES) City of Hope Medical Center US United States (USA) (US) University of Texas MD Anderson Cancer Center US United States (USA) (US) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) European Society for Blood and Marrow Transplantation EBMT NL Netherlands (NL) West Virginia University (WVU) US United States (USA) (US) Hôpital Saint-Antoine FR France (FR)

How to cite

APA:

Sahebi, F., Garderet, L., Kanate, A.S., Eikema, D.J., Knelange, N.S., Alvelo, O.F.,... Hari, P. (2018). Outcomes of Haploidentical Transplantation in Patients with Relapsed Multiple Myeloma: An EBMT/CIBMTR Report. Biology of Blood and Marrow Transplantation. https://dx.doi.org/10.1016/j.bbmt.2018.09.018

MLA:

Sahebi, Firoozeh, et al. "Outcomes of Haploidentical Transplantation in Patients with Relapsed Multiple Myeloma: An EBMT/CIBMTR Report." Biology of Blood and Marrow Transplantation (2018).

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