Allogeneic stem cell transplantation in multiple myeloma: single centre experience of 112 patients

Summary

At Helsinki University Central Hospital 112 patients with multiple myeloma (MM) have been treated with allogeneic stem cell transplantation (SCT) since 1995. The conditioning was at first myeloablative (MA), but reduced intensity conditioning (RIC) after autologous SCT has mostly been used since 1999. However, MA conditioning has been considered in young patients with aggressive disease. Of the patients 54 were male and 58 female. The median age at SCT was 50 (27–64) years. The median number of chemotherapy lines was 2 (range 1–7) before allogeneic SCT. In addition, prior autologous SCT had been performed in 71 patients. The median time from diagnosis to allogeneic SCT was 12 (4­–170) months, and the time between autologous and allogeneic SCT, 6 (2–142) months. At the time of allogeneic SCT 13 patients were in CR, 84 in PR, 4 had SD, and 11 were in progression. Eighty-six patients had a sibling donor and 26 patients had an HLA-matched unrelated donor. The conditioning was MA in 49 and RIC in 63 patients. Thirty patients received a BM graft and 82 patients a PB graft. The median follow-up time from allogeneic SCT was 43 (1–166) months. The OS was 50% at 95 months post-SCT and there were no deaths after 96 months (11 patients at risk). One hundred-day transplant-related mortality was 3.6% and that of the whole follow-up time was 10.8%. Thirty-eight patients have died. The cause of death was MM in 25 patients, GVHD in 7, and infection in 4. The present results show that with appropriate patient selection, allogeneic transplantation can be carried out in myeloma with low transplant-related mortality and encouraging survival rates. 

Keywords

myeloma, allogeneic stem cell transplantation, myeloablative and reduced intensity conditioning