scholarly journals Maintenance therapy with thalidomide improves overall survival after autologous hematopoietic progenitor cell transplantation for multiple myeloma

Cancer ◽  
2006 ◽  
Vol 106 (10) ◽  
pp. 2171-2180 ◽  
Author(s):  
Brett T. Brinker ◽  
Edmund K. Waller ◽  
Traci Leong ◽  
Leonard T. Heffner, Jr. ◽  
Istvan Redei ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Maintenance Therapy ◽  
Cell Transplantation ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor

“Secondary MGUS” After High-Dose Melphalan and Autologous Hematopoietic Progenitor Cell Transplantation In Multiple Myeloma: A Matter of Undetermined Significance.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1296-1296 ◽  
Author(s):  
Greg V. Manson ◽  
Erica L. Campagnaro ◽  
Pingfu Fu ◽  
Scott R Sommers ◽  
Christine A Curtis ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Cell Transplantation ◽  
Light Chain ◽  
Monoclonal Gammopathy ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
High Dose ◽  
Hematopoietic Progenitor ◽  
Significant Difference

Abstract Abstract 1296 New monoclonal gammopathies (secondary MGUS) sometimes appear after autologous hematopoietic progenitor cell transplantation (AHPCT) for multiple myeloma (MM). While the pathophysiology and prognostic significance of this phenomenon is incompletely defined, previously published series hypothesize that this phenomenon is due to recapitulation of early B-cell ontogeny, and suggest that it confers a more favorable prognosis.[1-3] We retrospectively reviewed immunoelectrophoretic data on MM patients who underwent AHPCT at University Hospitals Case Medical Center from January 2000 - May 2009, searching for development of secondary MGUS after AHPCT. Secondary MGUS was defined as the occurrence of a monoclonal gammopathy of a different isotype (i.e. change in either the heavy chain, light chain, or both) than the patient's previously identified MM-associated monoclonal gammopathy at any time point after AHPCT. We identified 89 MM patients who underwent AHPCT during that period. All patients received pre-transplant conditioning with melphalan 200 mg/m2 +/− TBI. Eighteen patients (20%) subsequently developed one or more secondary MGUS. There was no significant difference in age, gender, and stage of disease between patients who developed a secondary MGUS and those who did not (p=0.88). No patients who developed secondary MGUS had light-chain only disease at diagnosis. Nine patients developed a single new isotype, nine patients developed two or more new isotypes. The maximum number of new isotypes of monoclonal gammopathy in a single patient was six. Time to development of a secondary MGUS (latency) was highly variable, from 1.9 to 63.9 months, with a median of 10.5 months. One-third (33.3%) of patients who developed secondary MGUS developed their new isotype or isotypes more than a year after AHPCT. Amongst patients with secondary MGUS, the number of secondary isotypes was predictive of overall survival (OS). The hazard of death was 2.04 times higher with one increase of isotype (p = 0.016). There was a statistically significant association between latency to developing secondary MGUS and OS; for patients with latency ≤10 months, the median OS was 38 months, compared to 74 months for those with latency > 10 months (p = 0.023). Secondary MGUS is a phenomenon observed in a substantial subset of patients undergoing AHPCT for MM. Our study demonstrates that this phenomenon cannot be entirely attributed to immune reconstitution, as previously postulated, as one-third of patients developed secondary MGUS a year or more after AHPCT. While selection bias may explain why patients who have longer latency to secondary MGUS have significantly better overall survival, further study is needed to clarify predictors of developing secondary MGUS and the pathophysiology underlying this phenomenon. Figure 1 Overall survival by latency (cases with secondary MGUS only) Figure 1. Overall survival by latency (cases with secondary MGUS only) 1. Maisnar, V., et al., Isotype class switching after transplantation in multiple myeloma. Neoplasma, 2007. 54(3): p.225-8. 2. Zent, C.S., et al., Oligoclonal protein bands and Ig isotype switching in multiple myeloma treated with high-dose therapy and hematopoietic cell transplantation. Blood, 1998. 91(9): p.3518-23. 3. Mitus, A.J., et al., Monoclonal and oligoclonal gammopathy after bone marrow transplantation. Blood, 1989. 74(8): p. 2764-8. Disclosures: No relevant conflicts of interest to declare.

Disparities in Utilization of Autologous Hematopoietic Progenitor Cell Transplantation for Multiple Myeloma in the US

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 557-557
Author(s):  
Luciano J Costa ◽  
Jia-Xing Huang ◽  
Parameswaran N. Hari
Keyword(s):  
Multiple Myeloma ◽  
Cell Transplantation ◽  
Progenitor Cell ◽  
Conflicts Of Interest ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor ◽  
Pronounced Increase ◽  
Race Ethnicity ◽  
Sex Disparity ◽  
Racial Ethnic

Abstract Introduction: Autologous hematopoietic progenitor cell transplantation (AHPCT) is an established modality in the treatment of patients with multiple myeloma (MM) with impact in depth and duration of remission and, in some studies, overall survival. Utilization of AHPCT for treatment of MM in US is increasing but still low. Race-ethnicity, sex and age-disparities may affect AHPCT utilization, although they do not impact benefit from AHPCT. Methods: MM incidence derived from Surveillance, Epidemiology and End Results (SEER-18) database and AHPCT for MM reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between 2005-2009 were analyzed. Cases were grouped in 4 racial-ethnic categories (REC): non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), Hispanics (irrespective of race) and Asians. We assessed utilization as the ratio between first AHPCT for MM and number of newly diagnosed cases in the period of interest and calculated the relative utilization ratio (RUR), as [utilization for a given category] / [utilization for the entire population]. Results: Data was obtained from 22,462 actual MM cases reported to SEER and 13,311 actual AHPCT reported to CIBMTR. NHW, NHB, Hispanics and Asians corresponded respectively to 72.0%, 18.7%, 6.7% and 2.6% of the new MM cases and 77.4%, 15.85, 5.2% and 1.6% of the AHPCT procedures. Median age at diagnosis of MM was higher in NHW (P=0.0002)and was higher in women than in men in all RECs. Age-adjusted RUR was 1.17 (95% C.I. 1.15-1.19) among NHW, higher than in NHB [0.69 (95% C.I. 0.67-0.72), P<0.0002], Hispanics [0.64 (95% C.I. 0.60-0.69), p<0.002] and Asians [0.65 (95% C.I. 0.58-0.73), P<0.0002]. There was higher utilization of AHPCT in men than in women detected among Hispanics (age adjusted RUR 0.72 vs 0.56, P=0.007), but not among NHW, NHB or Asians. Only 3.1% of the NHW patients younger than 65 were identified as uninsured vs. 8.1% of NHB, 11.9% of Hispanics and 3.2% of Asians (P<0.0001). Correction of sex disparity would lead to an overall increase of 1.3% in AHPCT for MM, higher among Hispanics (11.7%) but lower in the other categories (Figure, panel a). The hypothetical correction of racial-ethnic disparity would result in 15.9% increase in volume of AHPCT, with a pronounced increase among NHB, Hispanics and Asians (Figure, panel b). Increase in age at transplant will strongly affect AHPCT volumes with dissimilar impact in different RECs according to their age structure (Figure, panel c). Conclusions: Race-ethnicity disparity greatly affects AHPCT utilization for management of MM in US. Sex disparity plays a much lesser role, except among Hispanics. The profound age disparity is decreasing over time and will likely continue to drive major increase of AHPCT activity. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Hematopoietic Progenitor Cell Transplantation in Multiple Myeloma

1995 ◽  
Vol 18 (6) ◽  
pp. 518-523
Author(s):  
H. Goldschmidt ◽  
U. Hegenbart ◽  
R. Haas ◽  
W. Hunstein
Keyword(s):  
Multiple Myeloma ◽  
Cell Transplantation ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor

scholarly journals Autologous hematopoietic progenitor cell transplantation for multiple myeloma through an outpatient program

2012 ◽  
Vol 12 (11) ◽  
pp. 1449-1462 ◽  
Author(s):  
Massimo Martino ◽  
Mauro Montanari ◽  
Benedetto Bruno ◽  
Giuseppe Console ◽  
Giuseppe Irrera ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Cell Transplantation ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor ◽  
Outpatient Program

scholarly journals Severe autologous GVHD after hematopoietic progenitor cell transplantation for multiple myeloma

2008 ◽  
Vol 43 (2) ◽  
pp. 169-177 ◽  
Author(s):  
W R Drobyski ◽  
P Hari ◽  
C Keever-Taylor ◽  
R Komorowski ◽  
W Grossman
Keyword(s):  
Multiple Myeloma ◽  
Cell Transplantation ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor
Sign in / Sign up

Export Citation Format

Share Document