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Allografting

Reduced-intensity conditioning allogeneic SCT as salvage treatment for relapsed multiple myeloma

Bone Marrow Transplantation volume 41, pages 953–960 (2008)Cite this article

Abstract

The aim of this retrospective analysis was to assess the benefit of reduced-intensity conditioning allo SCT (RIC allo-SCT) in a cohort of 32 relapsed multiple myeloma (MM) patients. A total of 19 patients had an HLA-identical sibling donor (‘donor’ group), while 13 patients had no donor (‘no-donor’ group). There were no significant differences between these two groups as for prognosis risk factors. Eighteen patients from the ‘donor’ group could actually proceed to RIC allo-SCT. With a median follow-up of 36 (range, 21–60) months, six patients died from transplant-related toxicity (cumulative incidence, 33% (95% CI, 11–55%)). Only 4 patients from the 18 transplanted patients (22%; 95% CI, 7–48%) progressed after RIC allo-SCT, as compared to 12 (86%; 95% CI, 56–98%; P=0.0003) among the nontransplanted patients. In an ‘intention-to-treat’ analysis, the Kaplan–Meier estimate of PFS was significantly higher in the ‘donor’ group as compared to the ‘no-donor’ group (P=0.01; 46 versus 8% at 3 years). There was no difference in terms of overall survival. However, in multivariate analysis, actual performance of RIC allo-SCT was associated with better PFS (relative risk, 0.35; 95% CI, 0.15–0.82; P=0.01). These data suggest a potential benefit for RIC allo-SCT in the management of relapsed MM warranting further prospective investigations.

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Acknowledgements

We thank the nursing staff for providing excellent care for our patients, and the physicians of the Hematology Department at the Institut Paoli-Calmettes for their important study contributions and dedicated patient care. We also thank the ‘Association pour la Recherche sur le Cancer (ARC)’ (Pole ARECA; ITAC protocols), the ‘Ligue Nationale contre le Cancer’, the ‘Fondation de France’, the ‘Fondation contre la Leucémie’, the ‘Agence de Biomédecine’, the ‘Association Cent pour Sang la Vie’ and the ‘Association Laurette Fuguain’, for their generous and continuous support for our clinical and basic research work. Our group is supported by several grants from the French ministry of health as part of the ‘Programme Hospitalier de Recherche Clinique (PHRC)’. HDL was supported by a grant from the ‘Fondation de France’ (Paris, France).

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Author notes

  1. D Blaise and M Mohty: These authors share senior authorship.

Authors and Affiliations

  1. Unité de Transplantation et de Thérapie Cellulaire (UTTC), Institut Paoli-Calmettes, Marseille, France

    H de Lavallade, J El-Cheikh, C Faucher, S Fürst, D Blaise & M Mohty

  2. Département d'Onco-Hématologie, Institut Paoli-Calmettes, Marseille, France

    J El-Cheikh, C Faucher, S Fürst, A-M Stoppa, D Coso, R Bouabdallah, C Chabannon, J-A Gastaut, D Blaise & M Mohty

  3. INSERM, UMR 599, Marseille, France

    C Chabannon, D Blaise & M Mohty

  4. Centre de Thérapie Cellulaire et Génique (CTCG), Institut Paoli-Calmettes, Marseille, France

    C Chabannon

  5. Université de la Méditerranée, Faculté de Médecine, Marseille, France

    J-A Gastaut, D Blaise & M Mohty

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  1. H de Lavallade
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Correspondence to M Mohty.

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de Lavallade, H., El-Cheikh, J., Faucher, C. et al. Reduced-intensity conditioning allogeneic SCT as salvage treatment for relapsed multiple myeloma. Bone Marrow Transplant 41, 953–960 (2008). https://doi.org/10.1038/bmt.2008.22

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  • DOI: https://doi.org/10.1038/bmt.2008.22

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