scholarly journals Reducing Treatment-Related Mortality Did Not Improve Outcomes of Allogeneic Myeloablative Hematopoietic Cell Transplantation for High-Risk Multiple Myeloma: A University of Michigan Prospective Series

2016 ◽  
Vol 22 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Attaphol Pawarode ◽  
Shin Mineishi ◽  
Pavan Reddy ◽  
Thomas M. Braun ◽  
Yasser A. Khaled ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
University Of Michigan ◽  
Treatment Related Mortality ◽  
Related Mortality

scholarly journals Trends in allogeneic stem cell transplantation for multiple myeloma: a CIBMTR analysis

Blood ◽  
2011 ◽  
Vol 118 (7) ◽  
pp. 1979-1988 ◽  
Author(s):  
Shaji Kumar ◽  
Mei-Jie Zhang ◽  
Peigang Li ◽  
Angela Dispenzieri ◽  
Gustavo A. Milone ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Unrelated Donor ◽  
Recent Cohort ◽  
Over Time ◽  
Treatment Related Mortality ◽  
Related Mortality

Abstract Allogeneic hematopoietic cell transplantation in multiple myeloma is limited by prior reports of high treatment-related mortality. We analyzed outcomes after allogeneic hematopoietic cell transplantation for multiple myeloma in 1207 recipients in 3 cohorts based on the year of transplantation: 1989-1994 (n = 343), 1995-2000 (n = 376), and 2001-2005 (n = 488). The most recent cohort was significantly older (53% > 50 years) and had more recipients after prior autotransplantation. Use of unrelated donors, reduced-intensity conditioning and the blood cell grafts increased over time. Rates of acute graft-versus-host (GVHD) were similar, but chronic GVHD rates were highest in the most recent cohort. Overall survival (OS) at 1-year increased over time, reflecting a decrease in treatment-related mortality, but 5-year relapse rates increased from 39% (95% confidence interval [CI], 33%-44%) in 1989-1994 to 58% (95% CI, 51%-64%; P < .001) in the 2001-2005 cohort. Projected 5-year progression-free survival and OS are 14% (95% CI, 9%-20%) and 29% (95% CI, 23%-35%), respectively, in the latest cohort. Increasing age, longer interval from diagnosis to transplantation, and unrelated donor grafts adversely affected OS in multivariate analysis. Survival at 5 years for subjects with none, 1, 2, or 3 of these risk factors were 41% (range, 36%-47%), 32% (range, 27%-37%), 25% (range, 19%-31%), and 3% (range, 0%-11%), respectively (P < .0001).

scholarly journals Adolescents and Young Adults with Acute Myeloid Leukemia Are Associated with Higher Treatment-Related Mortality and Inferior Overall Survival after Allogeneic Hematopoietic Cell Transplantation Compared with Children

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4702-4702
Author(s):  
Daisuke Tomizawa ◽  
Shiro Tanaka ◽  
Tadakazu Kondo ◽  
Yoshiko Hashii ◽  
Yasuyuki Arai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Cell Transplantation ◽  
Myeloid Leukemia ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Gvhd Prophylaxis ◽  
Treatment Related Mortality ◽  
Related Mortality ◽  
Acute Myeloid

Abstract BACKGROUND : There have been few reports on outcome of adolescent and young adults (AYAs) with acute myeloid leukemia (AML) who received allogeneic hematopoietic cell transplantation (allo-HCT). We performed a retrospective analysis of nationwide registration data of the Japan Society of Hematopoietic Cell Transplantation collected between 1990 and 2013 to assess the allo-HCT outcomes of AYA patients with AML in Japan. PATIENTS & METHODS : 2973 patients with de novo AML (excluding acute promyelocytic leukemia, myeloid leukemia associated with Down syndrome, and secondary AML) whose age was 0-29 years old at their first allo-HCT either in first or second remission (CR), primary induction failure, or first relapse were identified. Outcomes including overall survival rate (OS), disease-free survival rate (DFS), cumulative incidence of relapse (CIR), and treatment-related mortality (TRM) were compared between children (0-14 years old at HCT, N=1123) and AYAs (15-29 years old, N=1850). RESULTS : AYA patients had male predominance, higher incidence of intermediate risk cytogenetics but lower incidence of high-risk cytogenetics [-7/7q-, -5/5q-, complex karyotype, t(6;9), or t(16;21)], and higher prevalence of French-American-British M0, M1, and M2 morphology, while M5 and M7 were lower. Compared to children, AYA patients were transplanted more frequently by HLA-matched-related or unrelated donors, while less frequently by HLA-mismatched related or unrelated cord blood donors. As for conditioning regimen, proportion of myeloablative conditioning (MAC) using total-body-irradiation (TBI) was higher in the AYAs, while that of non-TBI MAC and reduced-intensity-conditioning (RIC) were lower. Cyclosporine was more frequently used than tacrolimus as graft-versus-host-disease (GVHD) prophylaxis in the AYAs. Five-year OS and DFS rates were significantly poorer in the AYAs: 58% vs 54% (p<0.01) and 53% vs 48% (p=0.03), respectively. Five-year CIR did not differ between the two groups; 33% vs 34% (p=0.99). However, 5-year TRM was significantly higher in the AYAs; 13% vs 16% (p=0.02). Multivariate analysis for both OS and TRM showed significant negative impact of AYAs, but not for DFS or CIR. Subgroup analyses showed that impact of AYAs for OS was greater in male, patients with low-risk cytogenetic abnormalities [t(8;21) or inv(16)], transplanted in CR, transplanted from HLA-matched related donor, received non-TBI MAC conditioning, or received cyclosporine-based GVHD prophylaxis. Finally, we analyzed the impact of transplant center types on HCT outcomes among the 317 adolescent patients (15-18 years old) who were transplanted at 1CR or 2CR, because they could be transplanted either by pediatricians or by adult hematologists according to their referral pattern. 92 cases were transplanted in pediatric centers, 203 in adult centers, and 22 in combined pediatric and adult centers. Basic characteristics and method of HCT did not differ significantly among the three groups. Interestingly, there was no difference in OS, DFS, CIR, or TRM. CONCLUSIONS : AYAs with AML showed inferior post-transplant survival, which was mainly due to higher TRM in the AYAs. Disclosures No relevant conflicts of interest to declare.

scholarly journals 90Y-labeled anti-CD45 antibody allogeneic hematopoietic cell transplantation for high-risk multiple myeloma

2020 ◽  
Vol 56 (1) ◽  
pp. 202-209 ◽  
Author(s):  
Sherilyn A. Tuazon ◽  
Brenda M. Sandmaier ◽  
Theodore A. Gooley ◽  
Darrell R. Fisher ◽  
Leona A. Holmberg ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation
Sign in / Sign up

Export Citation Format

Share Document