In a nutshell
This paper compared survival between autologous-allogeneic (auto/allo) and autologous-autologous (auto/auto) hematopoietic cell transplantation (HCT) in patients with relapsed multiple myeloma. This study concluded that survival after relapse was better in those who received auto/allo HCT compared to auto/auto HCT.
Some background
Multiple myeloma is a cancer of the plasma cells (type of white blood cell). Standard treatment involves high dose chemotherapy with autologous hematopoietic cell transplantation (HCT). However, patients often relapse (have a return of disease). HCT is a procedure whereby cells are taken from the bone marrow and transferred into the patient’s body. In autologous HCT, cells are taken from the patient’s own bone marrow. In allogeneic HCT, cells are taken from a donor. HCT can be given in two sessions. This can be both autologous HCT, termed auto/auto, or one autologous and one allogeneic HCT, termed auto/allo.
Methods & findings
This study compared outcomes between auto/allo and auto/auto HCT. 558 patients received auto/auto HCT. 264 patients received auto/allo HCT. 46% of patients who received auto/allo HCT relapsed within 6 months. 26% of patients who received auto/auto HCT relapsed within 6 months.
24% patients who received auto/allo HCT developed immediate graft vs host disease (complication of donor transplant).
After an average 102 months of follow-up after relapse, 38.2% patients in the auto/allo group had died. After an average 99 months of follow-up after relapse, 41% of patients who received auto/auto HCT had died. The average survival time from diagnosis to death was 86.3 months for the auto/allo group. The average survival was 75 months in auto/auto group.
In the first year after relapse, there was a similar risk of death between the 2 groups. However, beyond 12 months after relapse, patients who had received auto/auto HCT were 55% more at risk of death compared with those who received auto/allo HCT. When other factors were considered, the chance of survival 6 years after relapse was 45% for auto/allo patients. This chance was 35% for auto/auto patients.
The bottom line
The authors concluded that patients who underwent auto/allo HCT had a better long-term survival after relapse than patients who underwent auto/auto HCT.
Published By :
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Date :
Oct 24, 2017
