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Clinical Trial
. 2008 Oct;14(10):1118-1124.
doi: 10.1016/j.bbmt.2008.07.007.

Comparison of twin and autologous transplants for multiple myeloma

Asad Bashey  1 , Waleska S Pérez  2 , Mei-Jie Zhang  2 , Kenneth C Anderson  3 , Karen Ballen  4 , James R Berenson  5 , L Bik To  6 , Rafael Fonseca  7 , César O Freytes  8 , Robert Peter Gale  9 , John Gibson  10 , Sergio A Giralt  11 , Robert A Kyle  12 , Hillard M Lazarus  13 , Dipnarine Maharaj  14 , Philip L McCarthy  15 , Gustavo A Milone  16 , Stephen Nimer  17 , Santiago Pavlovsky  16 , Donna E Reece  18 , Gary Schiller  19 , David H Vesole  20 , Parameswaran Hari  21 ; Plasma Cell Disorders Working Committee
Affiliations
Clinical Trial

Comparison of twin and autologous transplants for multiple myeloma

Asad Bashey et al. Biol Blood Marrow Transplant. 2008 Oct.

Abstract

Relapse is the overwhelming cause of treatment failure after autologous transplantation for multiple myeloma (MM). For patients with a syngeneic donor, twin transplants provide a healthy graft that is free of myeloma. The relative impact of the graft on posttransplant relapse can be estimated by comparing risk of relapse after hematopoietic cell transplantation from genetically identical twins versus autotransplants because confounding differences in minor or major histocompatibility antigens are absent in the syngeneic transplant setting. Outcomes of 43 subjects who received twin transplants for MM were compared to 170 matched autotransplant recipients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Multivariate analysis was performed by fitting a Cox model stratified on matched pairs. The matched transplant patients studied were similar with respect to subject-, disease-, and transplant-related characteristics. Cumulative incidence of relapse/progression was significantly lower, and progression-free survival (PFS) was significantly higher following twin transplants. In multivariate analysis, the probability of relapse/progression was lower in twins (relative risk [RR] = 0.49, 95% confidence interval [CI] 0.28-0.86, P = .011). Twin transplants have a significantly lower relapse risk than autotransplants in MM, suggesting that graft composition may impact outcomes following high-dose chemotherapy.

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Figures

Figure 1
Figure 1
Cumulative incidence of relapse after hematopoietic stem cell transplantation for multiple myeloma, by type of transplant.
Figure 2
Figure 2
Probability of progression-free survival after hematopoietic stem cell transplantation for multiple myeloma, by type of transplant.
Figure 3
Figure 3
Probability of overall survival after hematopoietic stem cell transplantation for multiple myeloma, by type of transplant.
See this image and copyright information in PMC

References

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