Salvage Second Hematopoietic Cell Transplantation in Myeloma

Laura C. Michaelis; Ayman Saad; Xiaobo Zhong; Jennifer Le-Rademacher; Cesar O. Freytes; David I. Marks; Hillard M. Lazarus; Jennifer M. Bird; Leona A. Holmberg; Rammurti T. Kamble; Shaji Kumar; Michael Lill; Kenneth R. Meehan; Wael Saber; Jeffrey Schriber; Jason Tay; Dan T. Vogl; Baldeep M. Wirk; Bipin N. Savani; Robert P. Gale; David H. Vesole; Gary J. Schiller; Muneer H. Abidi; Kenneth C. Anderson; Taiga Nishihori; Matt E. Kalaycio; Julie M. Vose; Jan S. Moreb; William Drobyski; Reinhold Munker; Vivek Roy; Armin Ghobadi; H. Kent Holland; Rajneesh Nath; Luen Bik To; Angelo Maiolino; Adetola A. Kassim; Sergio A. Giralt; Heather J. Landau; Harry C. Schouten; Richard T. Maziarz; Joseph Mikhael; Tamila L. Kindwall-Keller; Patrick J. Stiff; John Gibson; Sagar Lonial; Amrita Y. Krishnan; Angela Dispenzieri; Parameswaran N. Hari

doi:10.1016/j.bbmt.2013.01.004

Salvage Second Hematopoietic Cell Transplantation in Myeloma

Laura C. Michaelis, Ayman Saad, Xiaobo Zhong, Jennifer Le-Rademacher, Cesar O. Freytes, David I. Marks, Hillard M. Lazarus, Jennifer M. Bird, Leona A. Holmberg, Rammurti T. Kamble, Shaji Kumar, Michael Lill, Kenneth R. Meehan, Wael Saber, Jeffrey Schriber, Jason Tay, Dan T. Vogl, Baldeep M. Wirk, Bipin N. Savani, Robert P. GaleDavid H. Vesole, Gary J. Schiller, Muneer H. Abidi, Kenneth C. Anderson, Taiga Nishihori, Matt E. Kalaycio, Julie M. Vose, Jan S. Moreb, William Drobyski, Reinhold Munker, Vivek Roy, Armin Ghobadi, H. Kent Holland, Rajneesh Nath, Luen Bik To, Angelo Maiolino, Adetola A. Kassim, Sergio A. Giralt, Heather J. Landau, Harry C. Schouten, Richard T. Maziarz, Joseph Mikhael, Tamila L. Kindwall-Keller, Patrick J. Stiff, John Gibson, Sagar Lonial, Amrita Y. Krishnan, Angela Dispenzieri, Parameswaran N. Hari^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing >= 36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing >= 36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.

Original language	English
Pages (from-to)	760-766
Journal	Biology of Blood and Marrow Transplantation
Volume	19
Issue number	5
DOIs	https://doi.org/10.1016/j.bbmt.2013.01.004
Publication status	Published - May 2013

Keywords

Second autologous transplantation
Multiple myeloma
Relapsed multiple myeloma

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Cite this

Michaelis, L. C., Saad, A., Zhong, X., Le-Rademacher, J., Freytes, C. O., Marks, D. I., Lazarus, H. M., Bird, J. M., Holmberg, L. A., Kamble, R. T., Kumar, S., Lill, M., Meehan, K. R., Saber, W., Schriber, J., Tay, J., Vogl, D. T., Wirk, B. M., Savani, B. N., ... Hari, P. N. (2013). Salvage Second Hematopoietic Cell Transplantation in Myeloma. Biology of Blood and Marrow Transplantation, 19(5), 760-766. https://doi.org/10.1016/j.bbmt.2013.01.004

@article{f95a4162bcad4c3abfa4cfede422060a,

title = "Salvage Second Hematopoietic Cell Transplantation in Myeloma",

abstract = "Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing >= 36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing >= 36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM. ",

keywords = "Second autologous transplantation, Multiple myeloma, Relapsed multiple myeloma",

author = "Michaelis, {Laura C.} and Ayman Saad and Xiaobo Zhong and Jennifer Le-Rademacher and Freytes, {Cesar O.} and Marks, {David I.} and Lazarus, {Hillard M.} and Bird, {Jennifer M.} and Holmberg, {Leona A.} and Kamble, {Rammurti T.} and Shaji Kumar and Michael Lill and Meehan, {Kenneth R.} and Wael Saber and Jeffrey Schriber and Jason Tay and Vogl, {Dan T.} and Wirk, {Baldeep M.} and Savani, {Bipin N.} and Gale, {Robert P.} and Vesole, {David H.} and Schiller, {Gary J.} and Abidi, {Muneer H.} and Anderson, {Kenneth C.} and Taiga Nishihori and Kalaycio, {Matt E.} and Vose, {Julie M.} and Moreb, {Jan S.} and William Drobyski and Reinhold Munker and Vivek Roy and Armin Ghobadi and Holland, {H. Kent} and Rajneesh Nath and To, {Luen Bik} and Angelo Maiolino and Kassim, {Adetola A.} and Giralt, {Sergio A.} and Landau, {Heather J.} and Schouten, {Harry C.} and Maziarz, {Richard T.} and Joseph Mikhael and Kindwall-Keller, {Tamila L.} and Stiff, {Patrick J.} and John Gibson and Sagar Lonial and Krishnan, {Amrita Y.} and Angela Dispenzieri and Hari, {Parameswaran N.}",

year = "2013",

month = may,

doi = "10.1016/j.bbmt.2013.01.004",

language = "English",

volume = "19",

pages = "760--766",

journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

publisher = "Elsevier Science",

number = "5",

}

Michaelis, LC, Saad, A, Zhong, X, Le-Rademacher, J, Freytes, CO, Marks, DI, Lazarus, HM, Bird, JM, Holmberg, LA, Kamble, RT, Kumar, S, Lill, M, Meehan, KR, Saber, W, Schriber, J, Tay, J, Vogl, DT, Wirk, BM, Savani, BN, Gale, RP, Vesole, DH, Schiller, GJ, Abidi, MH, Anderson, KC, Nishihori, T, Kalaycio, ME, Vose, JM, Moreb, JS, Drobyski, W, Munker, R, Roy, V, Ghobadi, A, Holland, HK, Nath, R, To, LB, Maiolino, A, Kassim, AA, Giralt, SA, Landau, HJ, Schouten, HC, Maziarz, RT, Mikhael, J, Kindwall-Keller, TL, Stiff, PJ, Gibson, J, Lonial, S, Krishnan, AY, Dispenzieri, A & Hari, PN 2013, 'Salvage Second Hematopoietic Cell Transplantation in Myeloma', Biology of Blood and Marrow Transplantation, vol. 19, no. 5, pp. 760-766. https://doi.org/10.1016/j.bbmt.2013.01.004

TY - JOUR

T1 - Salvage Second Hematopoietic Cell Transplantation in Myeloma

AU - Michaelis, Laura C.

AU - Saad, Ayman

AU - Zhong, Xiaobo

AU - Le-Rademacher, Jennifer

AU - Freytes, Cesar O.

AU - Marks, David I.

AU - Lazarus, Hillard M.

AU - Bird, Jennifer M.

AU - Holmberg, Leona A.

AU - Kamble, Rammurti T.

AU - Kumar, Shaji

AU - Lill, Michael

AU - Meehan, Kenneth R.

AU - Saber, Wael

AU - Schriber, Jeffrey

AU - Tay, Jason

AU - Vogl, Dan T.

AU - Wirk, Baldeep M.

AU - Savani, Bipin N.

AU - Gale, Robert P.

AU - Vesole, David H.

AU - Schiller, Gary J.

AU - Abidi, Muneer H.

AU - Anderson, Kenneth C.

AU - Nishihori, Taiga

AU - Kalaycio, Matt E.

AU - Vose, Julie M.

AU - Moreb, Jan S.

AU - Drobyski, William

AU - Munker, Reinhold

AU - Roy, Vivek

AU - Ghobadi, Armin

AU - Holland, H. Kent

AU - Nath, Rajneesh

AU - To, Luen Bik

AU - Maiolino, Angelo

AU - Kassim, Adetola A.

AU - Giralt, Sergio A.

AU - Landau, Heather J.

AU - Schouten, Harry C.

AU - Maziarz, Richard T.

AU - Mikhael, Joseph

AU - Kindwall-Keller, Tamila L.

AU - Stiff, Patrick J.

AU - Gibson, John

AU - Lonial, Sagar

AU - Krishnan, Amrita Y.

AU - Dispenzieri, Angela

AU - Hari, Parameswaran N.

PY - 2013/5

Y1 - 2013/5

N2 - Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing >= 36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing >= 36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.

AB - Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing >= 36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing >= 36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.

KW - Second autologous transplantation

KW - Multiple myeloma

KW - Relapsed multiple myeloma

U2 - 10.1016/j.bbmt.2013.01.004

DO - 10.1016/j.bbmt.2013.01.004

M3 - Article

C2 - 23298856

SN - 1083-8791

VL - 19

SP - 760

EP - 766

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 5

ER -