Outcomes of Haploidentical Transplantation in Patients with Relapsed Multiple Myeloma: An EBMT/CIBMTR Report

Firoozeh Sahebi*, Laurent Garderet, Abraham S. Kanate, Diderik-Jan Eikema, Nina Simone Knelange, Omar F. Davila Alvelo, Yener Koc, Didier Blaise, Qaiser Bashir, Jose M. Moraleda, Peter Dreger, James F. Sanchez, Stefan Ciurea, Harry Schouten, Nirav N. Shah, Mareike Verbeekl, Wolf Roesler, Jose L. Diez-Martin, Stefan Schoenland, Anita D'SouzaNicolaus Kroeger, Parameswaran Hari

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Web of Science)

Abstract

Allogeneic hematopoietic cell transplantation (allo-HCT) using siblings and matched donors has the potential for long-term disease control in a subset of high-risk patients with multiple myeloma (MM); however, the data on using haploidentical donors in this disease are limited. We conducted a retrospective analysis to examine the outcomes of patients with MM who underwent haploidentical allo-HCT within European Society for Blood and Marrow Transplantation/Center for International Blood and Marrow Transplant Research centers. A total of 96 patients underwent haploidentical allo-HCT between 2008 and 2016. With a median follow-up of 24.0 months (range, 13.2 to 24.9 months), 97% (95% confidence interval [CI], 93% to 100%) of patients had neutrophil engraftment by day 28, and 75% (95% CI, 66% to 84%) achieved platelet recovery by day 60. Two-year progression -free survival (PFS) was 17% (95% CI, 8% to 26%), and overall survival (OS) was 48% (95% CI, 36% to 59%). At 2 years, the cumulative risk of relapse/progression was 56% (95% CI, 45% to 67%), and 1-year nonrelapse mortality (NRM) was 21% (95% Cl, 13% to 29%). The incidences of acute graft-versus-host-disease (GVHD) grades ll-IV by 100 days and chronic GVHD at 2 years were 39% (95% CI, 28% to 49%) and 46% (95% CI, 34% to 59%), respectively. On univariate analysis, use of post-transplantation cyclophosphamide (PT-Cy) (54% [95% CI, 41% to 68%] versus 25% [95% CI, 1% to 48%]; P=.009) and use of bone marrow as source of stem cells (72% [95% CI, 55% to 89%] versus 31% [95% CI, 17% to 46%]; P=.001) were associated with improved OS at 2 years. Disease status, patient sex, intensity of conditioning regimen, recipient/donor sex mismatch, and cytomegalovirus serostatus had no impact on OS, PFS, or NRM. Haploidentical transplantation is feasible for patients with multiply relapsed or high-risk MM, with an encouraging 2-year OS of 48% and an NRM of 21% at 1 year, supporting further investigation of haploidentical allo-HCT in suitable candidates with MM. (C) 2018 American Society for Blood and Marrow Transplantation.

Original languageEnglish
Pages (from-to)335-342
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume25
Issue number2
DOIs
Publication statusPublished - Feb 2019

Keywords

  • Multiple myeloma
  • Haploidentical
  • Allogeneic hematopoietic cell transplantation
  • STEM-CELL TRANSPLANTATION
  • TANDEM AUTOLOGOUS TRANSPLANTATION
  • EUROPEAN-SOCIETY
  • MARROW
  • BLOOD
  • DONOR
  • LEUKEMIA

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