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Graft-versus-myeloma effect following antithymocyte globulin-based reduced intensity conditioning allogeneic stem cell transplantation.
Bone Marrow Transplant. 2004 Jul; 34(1):77-84.BM

Abstract

In all, 41 multiple myeloma (MM) patients received an antithymocyte globulin (ATG), fludarabine, and busulfan-based reduced intensity conditioning (RIC) for allogeneic stem cell transplantation (allo-SCT) from HLA-identical siblings. In total, 29 patients (70%) were in partial remission, one patient in complete remission, and 11 (27%) with progressive disease at the time of allo-SCT. Median time between diagnosis and allo-SCT was 24 months. The cumulative incidences of grade II-IV and grade III-IV acute graft-versus-host disease (GVHD) were 36% (95% CI, 21-51%) and 7% (95% CI, 2-20%), respectively. Overall, 10 patients developed limited chronic GVHD, whereas seven developed an extensive form (cumulative incidence, 41% (95% CI, 26-56%) at 2 years). With a median follow-up of 389 days, the overall cumulative incidence of transplant-related mortality (TRM) was 17% (95% CI, 6-28%). In all, 11 patients (27%) are in continuous complete remission, and the Kaplan-Meier estimates of overall survival (OS) and progression-free survival (PFS) at 2 years were 62% (95% CI, 47-76%) and 41% (95% CI, 23-62%), respectively. PFS and OS were significantly higher in patients with chronic GVHD as compared to patients without chronic GVHD (P=0.006 for PFS and P=0.01 for OS). Collectively, these data demonstrate that RIC allo-SCT can mediate a potentially curative graft-versus-myeloma effect with an acceptable incidence of toxicity and TRM.

Authors+Show Affiliations

Unité de Transplantation et de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France. mohtym@marseille.fnclcc.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15133485

Citation

Mohty, M, et al. "Graft-versus-myeloma Effect Following Antithymocyte Globulin-based Reduced Intensity Conditioning Allogeneic Stem Cell Transplantation." Bone Marrow Transplantation, vol. 34, no. 1, 2004, pp. 77-84.
Mohty M, Boiron JM, Damaj G, et al. Graft-versus-myeloma effect following antithymocyte globulin-based reduced intensity conditioning allogeneic stem cell transplantation. Bone Marrow Transplant. 2004;34(1):77-84.
Mohty, M., Boiron, J. M., Damaj, G., Michallet, A. S., Bay, J. O., Faucher, C., Perreau, V., Bilger, K., Coso, D., Stoppa, A. M., Tabrizi, R., Gastaut, J. A., Michallet, M., Maraninchi, D., & Blaise, D. (2004). Graft-versus-myeloma effect following antithymocyte globulin-based reduced intensity conditioning allogeneic stem cell transplantation. Bone Marrow Transplantation, 34(1), 77-84.
Mohty M, et al. Graft-versus-myeloma Effect Following Antithymocyte Globulin-based Reduced Intensity Conditioning Allogeneic Stem Cell Transplantation. Bone Marrow Transplant. 2004;34(1):77-84. PubMed PMID: 15133485.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Graft-versus-myeloma effect following antithymocyte globulin-based reduced intensity conditioning allogeneic stem cell transplantation. AU - Mohty,M, AU - Boiron,J M, AU - Damaj,G, AU - Michallet,A S, AU - Bay,J O, AU - Faucher,C, AU - Perreau,V, AU - Bilger,K, AU - Coso,D, AU - Stoppa,A M, AU - Tabrizi,R, AU - Gastaut,J A, AU - Michallet,M, AU - Maraninchi,D, AU - Blaise,D, PY - 2004/5/11/pubmed PY - 2005/2/17/medline PY - 2004/5/11/entrez SP - 77 EP - 84 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 34 IS - 1 N2 - In all, 41 multiple myeloma (MM) patients received an antithymocyte globulin (ATG), fludarabine, and busulfan-based reduced intensity conditioning (RIC) for allogeneic stem cell transplantation (allo-SCT) from HLA-identical siblings. In total, 29 patients (70%) were in partial remission, one patient in complete remission, and 11 (27%) with progressive disease at the time of allo-SCT. Median time between diagnosis and allo-SCT was 24 months. The cumulative incidences of grade II-IV and grade III-IV acute graft-versus-host disease (GVHD) were 36% (95% CI, 21-51%) and 7% (95% CI, 2-20%), respectively. Overall, 10 patients developed limited chronic GVHD, whereas seven developed an extensive form (cumulative incidence, 41% (95% CI, 26-56%) at 2 years). With a median follow-up of 389 days, the overall cumulative incidence of transplant-related mortality (TRM) was 17% (95% CI, 6-28%). In all, 11 patients (27%) are in continuous complete remission, and the Kaplan-Meier estimates of overall survival (OS) and progression-free survival (PFS) at 2 years were 62% (95% CI, 47-76%) and 41% (95% CI, 23-62%), respectively. PFS and OS were significantly higher in patients with chronic GVHD as compared to patients without chronic GVHD (P=0.006 for PFS and P=0.01 for OS). Collectively, these data demonstrate that RIC allo-SCT can mediate a potentially curative graft-versus-myeloma effect with an acceptable incidence of toxicity and TRM. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/15133485/Graft_versus_myeloma_effect_following_antithymocyte_globulin_based_reduced_intensity_conditioning_allogeneic_stem_cell_transplantation_ L2 - https://doi.org/10.1038/sj.bmt.1704531 DB - PRIME DP - Unbound Medicine ER -