Allogeneic transplant for multiple myeloma

This study examined the role of allogeneic hematopoietic stem cell transplantation in multiple myeloma. The study determined that allogeneic stem cell transplant is feasible for patients who have previously received other treatment.

Survival of patients with multiple myeloma has improved with the development of new medications and autologous stem cell transplantation (transplant using cells from the patient). However almost all patients relapse (have a return of disease). Another type of transplant, allogeneic hematopoietic stem cell transplantation (allo-HCT), uses cells from a donor. Allo-HCT could potentially cure multiple myeloma and it has seen increased use. However, it has a relatively high mortality rate and relapse rate. The role of allo-HCT in multiple myeloma is unclear. 

65 patients who underwent allo-HCT in Japan were studied. The average time between diagnosis and allo-HCT was 793 days. Patients had received an average of 3 lines of previous treatment and had received at least one new drug.

The overall response rate was 86.4%. The average time to best response was 2.8 months. Before allo-HCT treatment, 11% of patients had a complete response (no sign of cancer) to treatment. After allo-HCT, 27% of patients had a complete response to treatment. Patients survived an average 9.1 months without worsening disease. The average overall survival was 27.6 months. When various factors were considered, an age of 50 and more increased the risk of worsening disease. Overall survival was also worse compared to patients under 50 years.

At 1 year, 30% of patients had a relapse. At 3 years, 57.8% of patients had a relapse. At 3 years, 23.4% of patients had passed away without a relapse. The most common cause of these deaths was infection.

At 100 days, 44.8% of patients had a moderate to severe graft-versus-host disease (when the transplanted cells attack healthy tissue).

The authors concluded that allogeneic-HCT is feasible for patients who have already received multiple treatments. This is especially so for younger patients.

There was a small number of patients studied.