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Allogeneic stem cell transplantation reduces disease progression compared to autologous transplantation in patients with multiple myeloma

REYNOLDS, C ; RATANATHARATHORN, V ; FERRARA, J ; UBERTI, J ; ADAMS, P ; BRAUN, T ; SILVER, S ; AYASH, L ; CARSON, E ; EISBRUCH, A ; DAWSON, L. A ; MCDONAGH, K

Bone marrow transplantation (Basingstoke), 2001-04, Vol.27 (8), p.801-807 [Periódico revisado por pares]

Basingstoke: Nature Publishing Group

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Título:
Allogeneic stem cell transplantation reduces disease progression compared to autologous transplantation in patients with multiple myeloma
Autor: REYNOLDS, C ; RATANATHARATHORN, V ; FERRARA, J ; UBERTI, J ; ADAMS, P ; BRAUN, T ; SILVER, S ; AYASH, L ; CARSON, E ; EISBRUCH, A ; DAWSON, L. A ; MCDONAGH, K
Assuntos: Actuarial Analysis ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Antigens ; Autografts ; Biological and medical sciences ; Bone marrow ; Bone marrow transplantation ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Busulfan ; Cause of Death ; Cyclophosphamide ; Cyclosporins ; Disease Progression ; Female ; Graft versus host disease ; Graft vs Host Disease - etiology ; Graft vs Tumor Effect - physiology ; Graft-versus-host reaction ; Granulocyte colony-stimulating factor ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation - methods ; Hematopoietic Stem Cell Transplantation - standards ; Histocompatibility antigen HLA ; Humans ; Male ; Medical sciences ; Methotrexate ; Middle Aged ; Multiple myeloma ; Multiple Myeloma - mortality ; Multiple Myeloma - therapy ; Prophylaxis ; Statistical analysis ; Stem cell transplantation ; Stem cells ; Survival ; Survival Analysis ; Tacrolimus ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation, Autologous - standards ; Transplantation, Homologous - standards ; Transplants & implants ; Treatment Outcome
É parte de: Bone marrow transplantation (Basingstoke), 2001-04, Vol.27 (8), p.801-807
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
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Descrição: This study compares the probability of disease progression, progression-free survival, and overall survival between patients undergoing an allogeneic or autologous transplant for multiple myeloma using an identical preparative regimen. Patients received a preparative regimen of TBI, busulfan, and cyclophosphamide followed by an allogeneic or autologous transplant. In the allogeneic group (n = 21), six patients received bone marrow and 15 received G-CSF mobilized PBSC; all autologous patients (n = 35) received PBSC mobilized with cyclophosphamide and G-CSF. Allogeneic donors were HLA-identical (n = 20) or one-antigen mismatched (n = 1) siblings. Graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus (n = 10), tacrolimus/methotrexate (n = 6), cyclosporine/methotrexate (n = 4), or cyclosporine (n = 1). The groups were evenly matched for gender, pretransplant therapy, disease status at time of transplant, myeloma subtype, and time from diagnosis to transplant. The median age was significantly lower in the allogeneic group (48 vs 55 years, P < 0.01). In the allogeneic group the probabilities of developing acute GVHD grade II-IV and chronic GVHD were 55% and 82%, respectively. The Kaplan-Meier probability of disease progression was significantly lower in the allogeneic group (11% vs 64%, P < 0.001) compared to the autologous group. Although progression-free (60% vs 30%, P = 0.19) and overall survival at 2 years (60% vs 42%, P = 0.39) favored the allogeneic group, this did not reach statistical significance. Within the allogeneic transplant group, patients age 50 years or under had a 3-year overall survival significantly higher when compared to older patients (79% vs 29%, P = 0.03). Using identical preparative regimens, allogeneic transplantation reduced disease progression compared to autologous transplantation for myeloma. This suggests that allogeneic transplantation induces a graft-versus-myeloma (GVM) effect.
Editor: Basingstoke: Nature Publishing Group
Idioma: Inglês

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Allogeneic stem cell transplantation reduces disease progression compared to autologous transplantation in patients with multiple myeloma

REYNOLDS, C ; RATANATHARATHORN, V ; FERRARA, J ; UBERTI, J ; ADAMS, P ; BRAUN, T ; SILVER, S ; AYASH, L ; CARSON, E ; EISBRUCH, A ; DAWSON, L. A ; MCDONAGH, K

Basingstoke: Nature Publishing Group

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