Leukemia · 2019
Allogeneic transplantation in multiple myeloma: long-term follow-up and cytogenetic subgroup analysis.
Название и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Knop S, Engelhardt M, Liebisch P, Meisner C, Holler E, Metzner B, Peest D, Kaufmann M, Bunjes D, Straka C, Fischer T, Sezer O, Hentrich M, Ostermann H, Bassermann F, Hess G, Hertenstein B, Freund M, Kropff M, Schmidt CA, Wolf HH, Jung W, Frickhofen N, Mielke S, Bargou RC, Maschmeyer G, Svaldi M, Langer CH, Gramatzki M, Hebart H, Kanz L, Einsele H, Deutsche Studiengruppe Multiples Myelom
Аннотация
This phase 3 trial compared tandem autologous stem cell transplantation (autoSCT) versus autoSCT followed by reduced-intensity conditioning allogeneic stem cell transplantation (auto/alloSCT) in patients with newly diagnosed multiple myeloma (MM) with deletion of (del) chromosome 13q (del13q). The availability/absence of a human leukocyte antigen-matched-related or matched-unrelated donor (MUD) determined the nature of the second SCT. The primary endpoint was progression-free survival (PFS) in the intention-to-treat population (n = 199). Auto/alloSCT was performed in 126 patients; 74 received MUD allografts. After 91 months median follow-up, median PFS with auto/allo versus tandem autoSCT was 34.5 versus 21.8 months (P = 0.003; adjusted hazard ratio 0.55, 95% confidence interval 0.36-0.84). Median overall survival (OS) was 70.2 versus 71.8 months (P = 0.856). Two-year non-relapse mortality with auto/allo versus tandem autoSCT was 14.3% versus 4.1% (P = 0.008). In patients harboring both del13q and del17p, median PFS and OS were 37.5 and 61.5 months with auto/allo (n = 19) versus 6.1 and 23.4 months with tandem autoSCT (n = 6) (P = 0.0002 and 0.032). Our findings suggest that auto/alloSCT significantly extends PFS versus tandem autoSCT in del13q MM, and indicate some survival benefit for first-line alloSCT in high-risk MM.