Outcome of a Salvage Third Autologous Stem Cell Transplantation in Multiple Myeloma

被引：20

作者：

Garderet, Laurent ^{[1
]}

Iacobelli, Simona ^{[2
]}

Koster, Linda ^{[3
]}

Goldschmidt, Hartmut ^{[4
]}

Johansson, Jan-Erik ^{[5
]}

Bourhis, Jean Henri ^{[6
]}

Krejci, Marta ^{[7
]}

Leleu, Xavier ^{[8
]}

Potter, Michael ^{[9
]}

Blaise, Didier ^{[10
]}

Koenecke, Christian ^{[11
]}

Peschel, Christian ^{[12
]}

Radocha, Jakub ^{[13
]}

Metzner, Bernd ^{[14
]}

Lenain, Pascal ^{[15
]}

Schaefer-Eckart, Kerstin ^{[16
]}

Pohlreich, David ^{[17
]}

Grasso, Mariella ^{[18
]}

Caillot, Denis ^{[19
]}

Einsele, Herman ^{[20
]}

Ladetto, Marco ^{[21
]}

Schoenland, Stefan ^{[4
]}

Kroeger, Nicolaus ^{[22
]}

机构：

[1] Hop St Antoine, Dept Hematol, Paris, France

[2] Rome Univ Tor Vergata, Dept Stat, Rome, Italy

[3] European Soc Blood & Marrow Transplantat, Leiden, Netherlands

[4] Heidelberg Univ, Dept Hematol, Heidelberg, Germany

[5] Sahlgrens Univ Hosp, Dept Hematol, Gothenburg, Sweden

[6] Gustave Roussy Inst Cancerol, Dept Hematol, Villejuif, France

[7] Univ Hosp Brno, Dept Hematol, Brno, Czech Republic

[8] Hop La Miletrie, Dept Hematol, Poitiers, France

[9] Royal Marsden Hosp, Dept Hematol, London Surrey, England

[10] Inst Paoli Calmettes, Dept Hematol, Marseille, France

[11] Hannover Med Sch, Dept Hematol, Hannover, Germany

[12] Klinikum Rechts Der Isar, Dept Hematol, Munich, Germany

[13] Charles Univ Hosp, Dept Hematol, Hradec Kralove, Czech Republic

[14] Klinikum Oldenburg, Dept Hematol, Oldenburg, Germany

[15] Ctr Henri Becquerel, Dept Hematol, Rouen, France

[16] Klinikum Nurnberg, Dept Hematol, Nurnberg, Germany

[17] Charles Univ Hosp, Dept Hematol, Prague, Czech Republic

[18] Azienda Osped S Croce & Carle, Dept Hematol, Cuneo, Italy

[19] CHU Dijon, Dept Hematol, Dijon, France

[20] Univ Klinikum Wurzburg, Dept Internal Med 2, Wurzburg, Germany

[21] Azienda Osped SS Antonio & Biagio, Dept Hematol, Alessandria, Italy

[22] Eppendorf Univ Hosp, Dept Hematol, Hamburg, Germany

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2018年 / 24卷 / 07期

关键词：

Multiple myeloma; Relapse; Autologous hematopoietic cell transplantation; MARROW TRANSPLANTATION; AUTO-SCT; THERAPY; BLOOD; CHEMOTHERAPY; SURVIVAL; SOCIETY; IMPACT; TRIAL; ASCT;

D O I：

10.1016/j.bbmt.2018.01.035

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

To evaluate the outcomes of salvage third autologous stem cell transplantation (ASCT) in patients with relapsed multiple myeloma. We analyzed 570 patients who had undergone a third ASCT between 1997 and 2010 (European Society for Blood and Marrow Transplantation data), of whom 482 patients underwent tandem ASCT and a third ASCT at first relapse (AARA group) and 88 patients underwent an upfront ASCT with second and third transplantations after subsequent relapses (ARARA group). With a median follow-up after salvage third ASCT of 61 months in the AARA group and 48 months in the ARARA group, the day +100 nonrelapse mortality in the 2 groups was 4% and 7%, the incidence of second primary malignancy was 6% and 7%, the median progression-free survival was 13 and 8 months, and median overall survival (OS) was 33 and 15 months. In the AARA group, according to the relapse-free interval (RFI) from the second ASCT, the median OS after the third ASCT was 17 months if the RFI was <18 months, 37 months if the RFI was between 18 and 36 months, and 64 months if the RFI was >= 36 months (P < .001). In the ARARA group, the median OS after the third ASCT was 7 months if the RFI was <6 months, 13 months if the RFI was between 6 and 18 months, and 27 months if the RFI was >= 18 months (P < .001). In a multivariate analysis of the AARA group, the favorable prognostic factor was an RFI after second ASCT of >= 18 months. Progressive disease and a Karnofsky Performance Status score of <70 at third ASCT were unfavorable factors. A salvage third ASCT is of value for patients with relapsed myeloma, particularly for those with a long duration of response and chemosensitive disease at the time of transplantation. (C) 2018 American Society for Blood and Marrow Transplantation.

引用

页码：1372 / 1378

页数：7

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