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. 2021 Jun;100(6):1553-1567.
doi: 10.1007/s00277-021-04514-y. Epub 2021 Apr 17.

Long-term outcome after allogeneic stem cell transplantation in multiple myeloma

Sini Luoma  1 , Raija Silvennoinen  2   3 , Auvo Rauhala  4   5 , Riitta Niittyvuopio  2 , Eeva Martelin  2 , Vesa Lindström  2 , Jouni Heiskanen  2 , Liisa Volin  2 , Tapani Ruutu  2   6 , Anne Nihtinen  2   7
Affiliations

Long-term outcome after allogeneic stem cell transplantation in multiple myeloma

Sini Luoma et al. Ann Hematol. 2021 Jun.

Abstract

The role of allogeneic hematopoietic stem cell transplantation (allo-SCT) in multiple myeloma is controversial. We analyzed the results of 205 patients transplanted in one center during 2000-2017. 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. 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). Progression-free survival (PFS) was 2.4, 2.4, and 0.9 years, respectively (p < 0.001). Non-relapse mortality at 5 years was 8% overall, with no significant difference between the groups. Post-relapse survival was 4.1 years for upfront-allo and auto-allo, and 2.6 years for the relapse group (p = 0.066). Survival of high-risk patients was reduced. 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. Late relapses occurred in all groups. Allo-SCT resulted in long-term survival in a small subgroup of patients. Our results indicate that auto-allo-SCT is feasible and could be considered for younger patients in the upfront setting.

Keywords: Allogeneic stem cell transplantation; Conditioning; Graft-versus-host disease; Multiple myeloma; Post-relapse survival; Survival.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Overall survival (a), progression-free survival (b), and relapse incidence and non-relapse mortality (c) in the whole cohort, n = 205
Fig. 2
Fig. 2
Overall survival (a), progression-free survival (b), and relapse incidence and non-relapse mortality (c) according to the therapy group
See this image and copyright information in PMC

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