Abstract
Allogeneic stem cell transplantation (allo-SCT) offers a clinical option to young patients with multiple myeloma (MM) relapsing/progressing after autologous SCT (ASCT); however, this claim remains debatable. Thus, in this retrospective study, we analyzed 526 patients with MM who underwent SCT for MM relapsing/progressing after the prior ASCT using the registry data of the Japan Society for Hematopoietic Cell Transplantation (2001-2015) and compared overall survival (OS) between allo-SCT (n = 192) and autologous stem cell retransplantation groups (ReASCT; n = 334) based on risk factor points. Significant adverse factors for OS in all patients were (1) male sex, (2) less than partial response to SCT, (3) performance status of 2 to 4, and (4) short duration from the prior ASCT. We scored factor 2 as 1 point, factor 3 as 2 points, and factor 4 as 0, 1, or 2 points for more than 30, 9 to 30, or less than 9 months, respectively. We categorized patients into three risk subgroups based on their total points (0, 1-3, and 4-5 points), indicating the usefulness of this scoring system for prognosis prediction and treatment selection. Subgroup comparison revealed OS after ReASCT to be higher than that after allo-SCT in the intermediate-risk subgroup comprising the largest population (28.2% vs 21.5%, P <.004). We observed no significant advantages of allo-SCT over ReASCT in the low- and high-risk subgroups. These findings suggest that ReASCT is more advantageous than allo-SCT in many patients with MM relapsing/progressing after the prior ASCT. However, long-term survival patients were noted only in the allo-SCT group, and allo-SCT could exhibit clinical efficacy, particularly in the low-risk group. While further examination is warranted, allo-SCT could be a potential tool for a specific population with MM relapsing/progressing after the prior ASCT.
| Original language | English |
|---|---|
| Journal | Hematological Oncology |
| DOIs | |
| Publication status | Accepted/In press - 2019 Jan 1 |
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Keywords
- humans
- multiple myeloma
- prognosis
- stem cell transplantation
- treatment outcome
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research
Cite this
Comparison between autologous and allogeneic stem cell transplantation as salvage therapy for multiple myeloma relapsing/progressing after autologous stem cell transplantation. / Ikeda, Takashi; Mori, Keita; Kawamura, Koji; Mori, Takehiko; Hagiwara, Shotaro; Ueda, Yasunori; Kahata, Kaoru; Uchida, Naoyuki; Tsukada, Nobuhiro; Murakami, Satoshi; Yamamoto, Masahide; Takahashi, Tsutomu; Ichinohe, Tatsuo; Onizuka, Makoto; Atsuta, Yoshiko; Kanda, Yoshinobu; Okamoto, Shinichiro; Sunami, Kazutaka; Takamatsu, Hiroyuki.
In: Hematological Oncology, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison between autologous and allogeneic stem cell transplantation as salvage therapy for multiple myeloma relapsing/progressing after autologous stem cell transplantation
AU - Ikeda, Takashi
AU - Mori, Keita
AU - Kawamura, Koji
AU - Mori, Takehiko
AU - Hagiwara, Shotaro
AU - Ueda, Yasunori
AU - Kahata, Kaoru
AU - Uchida, Naoyuki
AU - Tsukada, Nobuhiro
AU - Murakami, Satoshi
AU - Yamamoto, Masahide
AU - Takahashi, Tsutomu
AU - Ichinohe, Tatsuo
AU - Onizuka, Makoto
AU - Atsuta, Yoshiko
AU - Kanda, Yoshinobu
AU - Okamoto, Shinichiro
AU - Sunami, Kazutaka
AU - Takamatsu, Hiroyuki
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Allogeneic stem cell transplantation (allo-SCT) offers a clinical option to young patients with multiple myeloma (MM) relapsing/progressing after autologous SCT (ASCT); however, this claim remains debatable. Thus, in this retrospective study, we analyzed 526 patients with MM who underwent SCT for MM relapsing/progressing after the prior ASCT using the registry data of the Japan Society for Hematopoietic Cell Transplantation (2001-2015) and compared overall survival (OS) between allo-SCT (n = 192) and autologous stem cell retransplantation groups (ReASCT; n = 334) based on risk factor points. Significant adverse factors for OS in all patients were (1) male sex, (2) less than partial response to SCT, (3) performance status of 2 to 4, and (4) short duration from the prior ASCT. We scored factor 2 as 1 point, factor 3 as 2 points, and factor 4 as 0, 1, or 2 points for more than 30, 9 to 30, or less than 9 months, respectively. We categorized patients into three risk subgroups based on their total points (0, 1-3, and 4-5 points), indicating the usefulness of this scoring system for prognosis prediction and treatment selection. Subgroup comparison revealed OS after ReASCT to be higher than that after allo-SCT in the intermediate-risk subgroup comprising the largest population (28.2% vs 21.5%, P <.004). We observed no significant advantages of allo-SCT over ReASCT in the low- and high-risk subgroups. These findings suggest that ReASCT is more advantageous than allo-SCT in many patients with MM relapsing/progressing after the prior ASCT. However, long-term survival patients were noted only in the allo-SCT group, and allo-SCT could exhibit clinical efficacy, particularly in the low-risk group. While further examination is warranted, allo-SCT could be a potential tool for a specific population with MM relapsing/progressing after the prior ASCT.
AB - Allogeneic stem cell transplantation (allo-SCT) offers a clinical option to young patients with multiple myeloma (MM) relapsing/progressing after autologous SCT (ASCT); however, this claim remains debatable. Thus, in this retrospective study, we analyzed 526 patients with MM who underwent SCT for MM relapsing/progressing after the prior ASCT using the registry data of the Japan Society for Hematopoietic Cell Transplantation (2001-2015) and compared overall survival (OS) between allo-SCT (n = 192) and autologous stem cell retransplantation groups (ReASCT; n = 334) based on risk factor points. Significant adverse factors for OS in all patients were (1) male sex, (2) less than partial response to SCT, (3) performance status of 2 to 4, and (4) short duration from the prior ASCT. We scored factor 2 as 1 point, factor 3 as 2 points, and factor 4 as 0, 1, or 2 points for more than 30, 9 to 30, or less than 9 months, respectively. We categorized patients into three risk subgroups based on their total points (0, 1-3, and 4-5 points), indicating the usefulness of this scoring system for prognosis prediction and treatment selection. Subgroup comparison revealed OS after ReASCT to be higher than that after allo-SCT in the intermediate-risk subgroup comprising the largest population (28.2% vs 21.5%, P <.004). We observed no significant advantages of allo-SCT over ReASCT in the low- and high-risk subgroups. These findings suggest that ReASCT is more advantageous than allo-SCT in many patients with MM relapsing/progressing after the prior ASCT. However, long-term survival patients were noted only in the allo-SCT group, and allo-SCT could exhibit clinical efficacy, particularly in the low-risk group. While further examination is warranted, allo-SCT could be a potential tool for a specific population with MM relapsing/progressing after the prior ASCT.
KW - humans
KW - multiple myeloma
KW - prognosis
KW - stem cell transplantation
KW - treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=85075477369&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075477369&partnerID=8YFLogxK
U2 - 10.1002/hon.2688
DO - 10.1002/hon.2688
M3 - Article
C2 - 31674032
AN - SCOPUS:85075477369
JO - Hematological Oncology
JF - Hematological Oncology
SN - 0278-0232
ER -