Outcome of a Salvage Third Autologous Stem Cell Transplantation in Multiple Myeloma

Laurent Garderet 1, * Simona Iacobelli 2 Linda Koster 3 Hartmut Goldschmidt 4 Jan-Erik Johansson 5 Jean Henri Bourhis 6 Marta Krejci 7 Xavier Leleu 8, 9 Michael Potter 10 Didier Blaise 11 Christian Koenecke 12 Christian Peschel 13 Jakub Radocha 14 Bernd Metzner 15 Pascal Lenain 16 Kerstin Schäfer-Eckart 17 David Pohlreich 18 Mariella Grasso 19 Denis Caillot 20 Herman Einsele 21 Marco Ladetto 22, 23 Stefan Schönland 24 Nicolaus Kröger 25
Abstract : To evaluate the outcomes of salvage third autologous stem cell transplantation (ASCT) in patients with relapsed multiple myeloma. We analyzed 570 patients who had undergone a third ASCT between 1997 and 2010 (European Society for Blood and Marrow Transplantation data), of whom 482 patients underwent tandem ASCT and a third ASCT at first relapse (AARA group) and 88 patients underwent an upfront ASCT with second and third transplantations after subsequent relapses (ARARA group). With a median follow-up after salvage third ASCT of 61 months in the AARA group and 48 months in the ARARA group, the day +100 nonrelapse mortality in the 2 groups was 4% and 7%, the incidence of second primary malignancy was 6% and 7%, the median progression-free survival was 13 and 8 months, and median overall survival (OS) was 33 and 15 months. In the AARA group, according to the relapse-free interval (RFI) from the second ASCT, the median OS after the third ASCT was 17 months if the RFI was <18 months, 37 months if the RFI was between 18 and 36 months, and 64 months if the RFI was ≥36 months (P < .001). In the ARARA group, the median OS after the third ASCT was 7 months if the RFI was <6 months, 13 months if the RFI was between 6 and 18 months, and 27 months if the RFI was ≥18 months (P < .001). In a multivariate analysis of the AARA group, the favorable prognostic factor was an RFI after second ASCT of ≥18 months. Progressive disease and a Karnofsky Performance Status score of <70 at third ASCT were unfavorable factors. A salvage third ASCT is of value for patients with relapsed myeloma, particularly for those with a long duration of response and chemosensitive disease at the time of transplantation.
Type de document :
Article dans une revue
Liste complète des métadonnées

https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01975406
Contributeur : Lnc - Université de Bourgogne <>
Soumis le : mercredi 9 janvier 2019 - 12:53:31
Dernière modification le : samedi 4 mai 2019 - 01:45:47

Identifiants

Citation

Laurent Garderet, Simona Iacobelli, Linda Koster, Hartmut Goldschmidt, Jan-Erik Johansson, et al.. Outcome of a Salvage Third Autologous Stem Cell Transplantation in Multiple Myeloma. Biology of Blood and Marrow Transplantation, Elsevier, 2018, 24 (7), pp.1372-1378. ⟨https://www.sciencedirect.com/science/article/pii/S1083879118300521?via%3Dihub⟩. ⟨10.1016/j.bbmt.2018.01.035⟩. ⟨hal-01975406⟩

Partager

Métriques

Consultations de la notice

28