The Role of Allogeneic Transplantation for Multiple Myeloma in the Era of Novel Agents: A Study from the Japanese Society of Myeloma
| Autor: | Nobuhiro Tsukada, Yoshinobu Kanda, Koji Kawamura, Tadao Ishida, Hirokazu Murakami, Takashi Ikeda, Yasunori Ueda, Kenshi Suzuki, Akiyo Yoshida |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Transplantation Conditioning Multivariate analysis Allogeneic transplantation medicine.medical_treatment Hematopoietic stem cell transplantation Young Adult 03 medical and health sciences 0302 clinical medicine Japan immune system diseases Internal medicine medicine Humans Transplantation Homologous Multiple myeloma Aged Retrospective Studies Transplantation business.industry Hazard ratio Hematopoietic Stem Cell Transplantation Retrospective cohort study Hematology Middle Aged medicine.disease Confidence interval Novel agents 030220 oncology & carcinogenesis Female Multiple Myeloma business 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation. 24:1392-1398 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2018.03.012 |
| Popis: | Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered a potentially curative therapy for patients with multiple myeloma, the role of allo-HSCT remains unclear in the novel agent era. We conducted a retrospective study of 65 patients with multiple myeloma who underwent allo-HSCT at 19 institutions from 2009 to 2016. Patients received a median of 3 (range, 1 to 7) lines of prior therapy, including at least 1 novel agent, except for autologous HSCT. The 3-year progression-free survival (PFS) and overall survival (OS) rates were 18.8% (95% confidence interval [CI], 9.6% to 30.3%) and 47.2% (95% CI, 33.9% to 59.4%), respectively. In a multivariate analysis, an age ≥50 years and less than a very good partial response (VGPR) before allo-HSCT were independent significant adverse factors for PFS (hazard ratio [HR], 2.30, P = .0063; HR, 2.86; P = .0059) and OS (HR, 2.37, P = .013; and HR, 2.74; P = .040). In contrast, the 3-year PFS and OS rates in patients50 years of age who achieved a VGPR or better before allo-HSCT were 64.3% (95% CI, 29.8% to 85.1%) and 80.2% (95% CI, 40.3% to 94.8%), respectively. The overall response rate was 86.4% (95% CI, 75.0% to 94.0%). The proportion of VGPR or better increased from 29% before allo-HSCT to 71% after allo-HSCT. The nonrelapse mortality at 3 years was 23.4% (95% CI, 13.8% to 34.4%). Only an age ≥50 years was associated with higher nonrelapse mortality (HR, 4.71; P = .015). We showed that allo-HSCT is feasible for heavily pretreated patients with multiple myeloma, even in the novel agent era. Allo-HSCT in particular is a promising therapy for young and chemosensitive patients. |
| Databáze: | OpenAIRE |
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