CD34-Selected Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Relapsed, High-Risk Multiple Myeloma

Eric Smith, Sean M. Devlin, Satyajit Kosuri, Evelyn Orlando, Heather Landau, Alex M. Lesokhin, David J. Chung, Hani Hassoun, Nikoletta Lendvai, Ola Landgren, Sergio Giralt, Ajai Chari, Sundar Jagannath, Guenther Koehne

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

We report results of a retrospective analysis of 44 patients with relapsed and high-risk multiple myeloma (MM) undergoing allogeneic CD34-selected hematopoietic stem cell transplantation (HSCT) from HLA-compatible donors. Patients had multiply relapsed disease including relapse at <15 months after autologous transplantation and most patients (28 of 44; 65%) also had high-risk cytogenetics. Before transplantation, patients received busulfan (8 mg/kg × 10 doses), melphalan (70 mg/m2 × 2 days), fludarabine (25 mg/m2 × 5 days), and rabbit antithymocyte globulin (2.5 mg/kg × 2 days). Patients with 10/10 HLA- matched donors were treated prophylactically with low doses of donor lymphocyte infusions (5 to 1 × 106 CD3+/kg) starting 4 to 6 months after CD34-selected HSCT. Acute (grade II to IV) graft-versus-host disease (GVHD) and transplantation-related mortality at 12 months were 2% and 18%, respectively. Chronic GVHD was not observed in any patient. Overall and progression-free survival at 2 years were 54% and 31%, respectively. By multivariate analyses, the outcomes of CD34-selected HSCT were influenced by presence of extramedullary disease, disease status before CD34-selected HSCT, and age. This study demonstrates notable safety and efficacy of CD34-selected HSCT in patients with multiply relapsed MM, including those with high-risk cytogenetics.

Original languageEnglish (US)
Pages (from-to)258-267
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Keywords

  • Adoptive immunotherapy
  • D34-selected hematopoietic stem cell transplantation
  • Relapsed high-risk multiple myeloma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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