In a nutshell
This article investigated the long-term safety and effectiveness of tandem autologous/allogeneic hematopoietic cell transplantation (auto/alloHCT) for patients with multiple myeloma (MM). The authors concluded that this therapy is safe and can improve the overall survival of these patients.
Some background
Allogenic HCT (healthy stem cells are collected from a matching donor and transplanted into the patient to suppress the disease and restore the patient's immune system) is a current standard treatment for patients with MM. However, it is associated with high death rates.
An alternative treatment is high-dose chemotherapy before autologous HCT. This treatment uses high dose chemotherapy which destroys cancer cells. It is followed then by a transplant of healthy cells that had been previously removed from the patient and stored. This treatment is then followed by an allogeneic HCT (auto/alloHCT). The effects on overall survival and safety of auto/alloHCT in patients with multiple myeloma are still under investigation.
Methods & findings
This study involved 244 patients with MM. 209 patients received auto/alloHCT as first-line treatment. 35 patients failed the previous autoHCT before having the auto/alloHCT. The outcomes measured were progression-free survival (PFS; the time it took for cancer to start growing again), and overall survival (OS).
After an average follow-up of 8.3 years, the average OS was 6.4 years and average PFS was 1.9 years. The 5-year OS (number of patients alive after 5 years) was 54%. The 5-year PFS (the percentage of patients alive without tumor growth 5 years later) was 31%. 10-year OS and PFS were 41% and 19%.
The bottom line
The authors concluded that auto/alloHCT was safe and effective on the long-term in patients with MM.
The fine print
Patients with ultra high-risk disease did not have the same benefit from the treatment. Further studies are needed to research treatment options for these patients.
Published By :
Haematologica
Date :
Sep 27, 2018
