Long-term outcomes of allogeneic stem cell transplant in multiple myeloma.
Walker M SchmidtNirosha D PereraFrancis K BuadiSuzanne R HaymanShaji K KumarAngela DispenzieriDavid DingliJoselle Madonna CookMartha Q LacyPrashant KapoorNelson LeungEli MuchtarRahma M WarsameTaxiarchis V KourelisMoritz BinderWilson I GonsalvesWilliam Joseph HoganMorie A GertzPublished in: Blood cancer journal (2023)
Allogeneic stem cell transplant (allo SCT) for multiple myeloma (MM) is potentially curative in some, while toxic in many others. We retrospectively analyzed 85 patients diagnosed with MM who underwent allo SCT as frontline or salvage therapy between 2000 and 2022 at Mayo Clinic Rochester and examined patient outcomes and prognostic markers. Overall survival (OS), progression free survival (PFS), treatment related mortality (TRM), and relapse rates (RR) were estimated using the Kaplan Meier method and competing risk models. Median follow-up was 11.5 years. Median OS and PFS were 1.7 and 0.71 years, respectively. Five-year OS and PFS were 22.2% and 15.1%, respectively. One-year TRM was 23.5%. Twelve patients demonstrated durable overall survival, living 10+ years beyond their allo SCT. This subgroup was more likely to have no or one prior auto SCT (p = 0.03) and to have been transplanted between 2000 and 2010 (p = 0.03). Outcomes were poor in this cohort with long follow-up, with few patients surviving 5 years or more, and most relapsing or dying within 2 years. We would expect better outcomes and tolerability with an expanded array of novel therapeutics and would prefer them to allo SCT.
Keyphrases
- end stage renal disease
- free survival
- newly diagnosed
- ejection fraction
- chronic kidney disease
- prognostic factors
- multiple sclerosis
- peritoneal dialysis
- stem cell transplantation
- type diabetes
- cardiovascular disease
- small molecule
- low dose
- coronary artery disease
- systemic lupus erythematosus
- high resolution
- metabolic syndrome
- patient reported outcomes
- rectal cancer
- mass spectrometry
- open label
- smoking cessation
- glycemic control