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Myeloma

Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect

Bone Marrow Transplantation volume 28, pages 841–848 (2001)Cite this article

Abstract

We report a series of 37 consecutive patients with multiple myeloma (MM) who received an allograft between 1990 and 2000 at our institution. Median age was 47 years, and nearly 70% of patients were Durie–Salmon stage III. A median of five cycles of chemotherapy were given before transplant, with a median interval between diagnosis and transplant of 9.3 months. We report a nonrelapse mortality rate of 22% with a median follow-up period of 40 months, whereas complete remission (CR) rate at 12 months is estimated at 57%. Treatment failure rate and overall survival at 40 months are estimated at 52% and 32%, respectively. The number of chemotherapy cycles prior to allotransplantation achieved borderline statistical significance as a poor prognosis factor for overall survival (P = 0.05), while the presence of chronic graft-versus-host disease (cGVHD) was significantly correlated with CR achievement (P = 0.036). Our study confirms that early allografting in MM can yield toxicity rates significantly lower than those associated with historical cohorts, and supports the hypothesis that cumulative chemotoxicity has a negative influence on mortality and survival rates. More importantly, our study clearly demonstrates an association between cGVHD and CR and brings further evidence in favor of a graft-versus-myeloma effect. Bone Marrow Transplantation (2001) 28, 841–848.

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Acknowledgements

Dr Le Blanc is the recipient of a Fujisawa Canada fellowship.

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Authors and Affiliations

  1. Division of Hematology-Immunology, Hôpital Maisonneuve-Rosemont, Montreal, Canada

    R Le Blanc, S Montminy-Métivier, R Bélanger, L Busque, D Fish, D-C Roy, J Kassis, J Boileau, R Lavallée, D Bélanger, F Letendre, J Hébert, G Sauvageau, C Perreault & J Roy

  2. Department of Medicine, Université de Montréal, Montréal, Québec, Canada

    R Le Blanc, S Montminy-Métivier, R Bélanger, L Busque, D Fish, D-C Roy, J Kassis, J Boileau, R Lavallée, D Bélanger, F Letendre, J Hébert, G Sauvageau, C Perreault & J Roy

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Le Blanc, R., Montminy-Métivier, S., Bélanger, R. et al. Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect. Bone Marrow Transplant 28, 841–848 (2001). https://doi.org/10.1038/sj.bmt.1703253

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