Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party

Bone Marrow Transplantation, vol. 56, pp. 2367–2381

Abstract

The EBMT Chronic Malignancies Working Party performed a retrospective analysis of 215 patients who underwent a second allo-HCT for myeloma between 1994 and 2017, 159 for relapse and 56 for graft failure. In the relapse group, overall survival (OS) was 38% (30-46%) at 2 years and 25% (17-32%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib/HLAid-Sib: 35% (24-46%); Others 9% (0-17%), p < 0.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib/HLAid-Sib: 50% (33-67%); Other 22% (8-36%), p = 0.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21-40%) vs. 10% (1-20%), P = 0.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24-0.67), p < 0.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.

Authors 28

1. Patrick John Hayden corresponding

   Trinity College Dublin · St. James's Hospital

   Affiliation as printed

   Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland. phayden@stjames.ie

   Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland

2. Dirk‐Jan Eikema Aachen EBMT Statistical Unit

   European Society for Blood and Marrow Transplantation

   Affiliation as printed

   EBMT Statistical Unit, Leiden, The Netherlands

3. Liesbeth C. de Wreede Aachen Department of Biomedical Data Sciences

   Leiden University Medical Center

   Affiliation as printed

   Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands

4. Linda Köster Aachen EBMT Data Office Leiden

   European Society for Blood and Marrow Transplantation

   Affiliation as printed

   EBMT Data Office Leiden, Leiden, The Netherlands

5. Nicolaus Martin Kröger

   Universität Hamburg · University Medical Center Hamburg-Eppendorf

   Affiliation as printed

   University Hospital Eppendorf, Hamburg, Germany

6. Hermann Einsele

   Universitätsklinikum Würzburg

   Affiliation as printed

   Universitätsklinikum Würzburg, Würzburg, Germany

7. Monique C. Minnema

   University Medical Center Utrecht

   Affiliation as printed

   University Medical Center Utrecht, Utrecht, The Netherlands

8. Alida Dominietto

   Ospedale Policlinico San Martino

   Affiliation as printed

   IRCCS Ospedale Policlinico San Martino, Genova, Italy

9. Michael N Potter

   Royal Marsden Hospital

   Affiliation as printed

   Royal Marsden Hospital, London, UK

10. Jakob Robert Passweg

    University Hospital of Basel

    Affiliation as printed

    University Hospital, Basel, Switzerland

11. Arancha Bermúdez

    Marqués de Valdecilla University Hospital

    Affiliation as printed

    Hospital Universitario Marqués de Valdecilla, Santander, Spain

12. Stéphanie Nguyen

    Pitié-Salpêtrière Hospital

    Affiliation as printed

    Hopital la Pitié-Salpêtrière, Paris, France

13. Uwe Platzbecker
    Affiliation as printed

    Medical Clinic and Policinic 1, Leipzig, Germany

14. Johanna Tischer

    München Klinik

    Affiliation as printed

    Klinikum Grosshadern, Munich, Germany

15. Fabio Ciceri

    IRCCS Ospedale San Raffaele

    Affiliation as printed

    Ospedale San Raffaele s.r.l., Milano, Italy

16. Hendrik Veelken Aachen Leiden

    Leiden University

    Affiliation as printed

    Leiden University Hospital, Leiden, The Netherlands

17. Per T Ljungman

    Karolinska University Hospital

    Affiliation as printed

    Karolinska University Hospital, Stockholm, Sweden

18. Nicolaas PM Schaap

    Radboud University Nijmegen · Radboud University Medical Center

    Affiliation as printed

    Radboud University Medical Centre, Nijmegen, The Netherlands

19. Édouard Forcade

    Centre Hospitalier Universitaire de Bordeaux

    Affiliation as printed

    CHU Bordeaux, Pessac, France

20. Angelo Michele Carella

    Casa Sollievo della Sofferenza

    Affiliation as printed

    Casa Sollievo della Sofferenza, San Giovanni, Italy

21. Virginie Gandemer

    Centre Hospitalier Universitaire de Rennes

    Affiliation as printed

    Centre Hospitalier Universitaire de Rennes Hôpital sud, Rennes, France

22. William Arcese

    University of Rome Tor Vergata

    Affiliation as printed

    Rome Transplant Network ¨Tor Vergata¨ University of Rome, Rome, Italy

23. Adrian John Clifton Bloor

    The Christie Hospital · The Christie NHS Foundation Trust

    Affiliation as printed

    Christie NHS Trust Hospital, Manchester, UK

24. Attilio Olivieri

    Azienda Ospedaliero-Universitaria delle Marche

    Affiliation as printed

    Azienda Ospedali Riuniti di Ancona, Ancona, Italy

25. Laure Vincent

    Hôpital Lapeyronie

    Affiliation as printed

    CHU Lapeyronie, Montpellier, France

26. Meral Beksaç

    Ankara University

    Affiliation as printed

    Ankara University Faculty of Medicine, Ankara, Turkey

27. Stefan Olaf Schönland

    University Hospital Heidelberg

    Affiliation as printed

    Medical Department V, University Hospital Heidelberg, Heidelberg, Germany

28. Ibrahim Yakoub‐Agha

    Inserm · Université de Lille · Centre Hospitalier Universitaire de Lille · Institute for Translational Research in Inflammation

    Affiliation as printed

    Univ. Lille, CHU Lille, INSERM, Infinite, U1286, Lille, France