¹The Myeloma Institute for Research and Therapy, The University of Arkansas for Medical Sciences, Little Rock, AR, USA

Correspondence: Dr C-K Lee, Blood and Marrow Transplant Program, The University of Michigan, B1-207 CCGC, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0914, USA. E-mail: cholee@umich.edu

Received 31 August 2005; Revised 7 November 2005; Accepted 8 November 2005; Published online 23 January 2006.

Abstract

To identify a correlation between metaphase cytogenetics and relapse after reduced intensity conditioning (RIC) allotransplant for patients with multiple myeloma, data on 60 patients (median age 52) who received grafts from a sibling (n=49) or unrelated donor (n=11) were analyzed. Fifty-three patients (88%) showed chromosomal abnormalities (CA) before the allotransplant, including 42 with abnormalities involving 13q (CA13). Twenty-two patients (41%) relapsed post-allotransplant at a median of 165 days. Of these, 11 patients showed abnormal cytogenetics at the time of post-allotransplant relapse at a median of 167 days. Of 54 patients who developed graft-versus-host disease, relapse occurred in 19 of 48 patients (43%) with CA present before RCI allotransplant, versus 1 of 6 without CA (17%) (P=0.06). Loss of CA before RIC allotransplant and disease status>PR after RIC allotransplant were significantly associated with a lower risk of post-allotransplant relapse with cytogenetic abnormalities; 5.2 vs 36%, and 18 vs 53%, (both P<0.05), respectively. The current data suggests that myeloma associated with persistent clonal cytogenetic abnormalities is an entity which most likely escapes the effects of a graft versus myeloma activity, maybe because of acquisition of resistance to immunologic manipulations.