12th Congress of the European Hematology ... - Haematologica

Myeloma and other monoclonal gammopathies -
Clinical II
0671
REDUCED INTENSITY CONDITIONING ALLOGENEIC TRANSPLANTATION IN MULTIPLE
MYELOMA. A SINGLE CENTER EXPERIENCE
G. Marit, 1 A. Schmitt, 1 R. Tabrizi, 1 M. Sauvezie, 1 J.M. Boiron, 2
K. Bouabdallah, 1 A. Pigneux, 1 T. Leguay, 1 M.S. Dilhuydy, 1 V. Frossard, 1
C. Melot, 1 N. Milpied 1
1 CHU Bordeaux, PESSAC; 2 EFSAL, BORDEAUX, France
The role of AT is still controversial in the management of MM
patients. In order to identify factors influencing the outcome post graft
we analyzed the results of RIC AT performed in 45 MM patients of our
institution between June 1999 and August 2006. Median interval
between diagnosis and AT was of 32 months (range: 7-172). At time of
AT, median age was 57 years (range: 44-64), 37 patients were considered
as complete (n=2) or partial (n=35) responders. Before AT 13 patients
received only one line ot treatment as the 32 other received two or more
lines of treatment. The number of autograft before AT was none or one
in 25 cases and two or more in 19 cases. RIC regimen consisted of fludarabine
associated with busulfan (n=32), total body irradiation (n=9),
treosulfan (n=2), idarubicine and cytosine arabinoside (n=1) or melphalan
(n=1). In addition 34 patients received ATG. The donor was an HLAidentical
sibling in 30 cases or an unrelated donor in 15 cases (HLA-identical:
11 or HLA mis-match: 4). With a median follow-up of 27 months
(range:4-84), 17 patients are alive and 28 are dead. The causes of death
were: transplant-related complications (n=13), relapse or progression
(n=14) and secondary malignancy (n=1). The 3-year event free survival
(EFS) and overall survival (OS) from AT were respectively 20±6.9%
(95%CI) and 34±38.4% (95%CI). The complete remission (CR) rate
after AT was 40% for the 42 patients who engrafted. The median EFS
duration from AT for patients achieving CR was 31 months (range:3-56).
Univariate analysis showed that obtention of CR post-AT and occurrence
of chronic GVHD were the factors who had a significant impact
on EFS and OS (p