Salvage Second Hematopoietic Cell Transplantation in Myeloma

Laura C. Michaelis; Ayman Saad; Xiaobo Zhong; Jennifer Le-Rademacher; Cesar O. Freytes; David I. Marks; Hillard M. Lazarus; Jennifer M. Bird; Leona Holmberg; Rammurti T. Kamble; Shaji Kumar; Michael Lill; Kenneth R. Meehan; Wael Saber; Jeffrey Schriber; Jason Tay; Dan T. Vogl; Baldeep Wirk; Bipin N. Savani; Robert P. Gale; David H. Vesole; Gary J. Schiller; Muneer Abidi; Kenneth C. Anderson; Taiga Nishihori; Matt E. Kalaycio; Julie M. Vose; Jan S. Moreb; William Drobyski; Reinhold Munker; Vivek Roy; Armin Ghobadi; H. Kent Holland; Rajneesh Nath; L. Bik To; Angelo Maiolino; Adetola A. Kassim; Sergio A. Giralt; Heather Landau; Harry C. Schouten; Richard T. Maziarz; Joseph Michael; Tamila Kindwall-Keller; Patrick J. Stiff; John Gibson; Sagar Lonial; Amrita Krishnan; Angela Dispenzieri; Parameswaran Hari

doi:10.1016/j.bbmt.2013.01.004

Salvage Second Hematopoietic Cell Transplantation in Myeloma

Laura C. Michaelis
, Ayman Saad
, Xiaobo Zhong
, Jennifer Le-Rademacher
, Cesar O. Freytes
, David I. Marks
, Hillard M. Lazarus
, Jennifer M. Bird
, Leona Holmberg
, Rammurti T. Kamble
, Shaji Kumar
, Michael Lill
, Kenneth R. Meehan
, Wael Saber
, Jeffrey Schriber
, Jason Tay
, Dan T. Vogl
, Baldeep Wirk
, Bipin N. Savani
, Robert P. Gale

David H. Vesole, Gary J. Schiller, Muneer Abidi, Kenneth C. Anderson, Taiga Nishihori, Matt E. Kalaycio, Julie M. Vose, Jan S. Moreb, William Drobyski, Reinhold Munker, Vivek Roy, Armin Ghobadi, H. Kent Holland, Rajneesh Nath, L. Bik To, Angelo Maiolino, Adetola A. Kassim, Sergio A. Giralt, Heather Landau, Harry C. Schouten, Richard T. Maziarz, Joseph Michael, Tamila Kindwall-Keller, Patrick J. Stiff, John Gibson, Sagar Lonial, Amrita Krishnan, Angela Dispenzieri, Parameswaran Hari

Department of Medicine

Research output: Contribution to journal › Article › peer-review

102 Scopus citations

Abstract

Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing ≥36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing ≥36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.

Original language	English (US)
Pages (from-to)	760-766
Number of pages	7
Journal	Biology of Blood and Marrow Transplantation
Volume	19
Issue number	5
DOIs	https://doi.org/10.1016/j.bbmt.2013.01.004
State	Published - May 2013

All Science Journal Classification (ASJC) codes

Hematology
Transplantation

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10.1016/j.bbmt.2013.01.004

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Michaelis, L. C., Saad, A., Zhong, X., Le-Rademacher, J., Freytes, C. O., Marks, D. I., Lazarus, H. M., Bird, J. M., Holmberg, L., Kamble, R. T., Kumar, S., Lill, M., Meehan, K. R., Saber, W., Schriber, J., Tay, J., Vogl, D. T., Wirk, B., Savani, B. N., ... Hari, P. (2013). Salvage Second Hematopoietic Cell Transplantation in Myeloma. Biology of Blood and Marrow Transplantation, 19(5), 760-766. https://doi.org/10.1016/j.bbmt.2013.01.004

@article{d8c6f2413d634bc59ab3d4c339081616,

title = "Salvage Second Hematopoietic Cell Transplantation in Myeloma",

abstract = "Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2\% at 1 year and 4\% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51\% and 82\%, respectively. At 3 years after AHCT2, progression-free survival was 13\%, and overall survival was 46\%. In multivariate analyses, those relapsing ≥36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing ≥36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.",

author = "Michaelis, \{Laura C.\} and Ayman Saad and Xiaobo Zhong and Jennifer Le-Rademacher and Freytes, \{Cesar O.\} and Marks, \{David I.\} and Lazarus, \{Hillard M.\} and Bird, \{Jennifer M.\} and Leona Holmberg and Kamble, \{Rammurti T.\} and Shaji Kumar and Michael Lill and Meehan, \{Kenneth R.\} and Wael Saber and Jeffrey Schriber and Jason Tay and Vogl, \{Dan T.\} and Baldeep Wirk and Savani, \{Bipin N.\} and Gale, \{Robert P.\} and Vesole, \{David H.\} and Schiller, \{Gary J.\} and Muneer Abidi and Anderson, \{Kenneth C.\} and Taiga Nishihori and Kalaycio, \{Matt E.\} and Vose, \{Julie M.\} and Moreb, \{Jan S.\} and William Drobyski and Reinhold Munker and Vivek Roy and Armin Ghobadi and Holland, \{H. Kent\} and Rajneesh Nath and To, \{L. Bik\} and Angelo Maiolino and Kassim, \{Adetola A.\} and Giralt, \{Sergio A.\} and Heather Landau and Schouten, \{Harry C.\} and Maziarz, \{Richard T.\} and Joseph Michael and Tamila Kindwall-Keller and Stiff, \{Patrick J.\} and John Gibson and Sagar Lonial and Amrita Krishnan and Angela Dispenzieri and Parameswaran Hari",

note = "Funding Information: Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI) , the National Heart, Lung and Blood Institute (NHLBI) , and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI ; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS) ; two grants, N00014-06-1-0704 and N00014-08-1-0058 , from the Office of Naval Research ; and grants from Allos, Inc. ; Amgen, Inc. ; Angioblast; Anonymous donation to the Medical College of Wisconsin ; Ariad ; Be the Match Foundation ; Blue Cross and Blue Shield Association ; Buchanan Family Foundation ; CaridianBCT ; Celgene Corporation ; CellGenix, GmbH ; Children's Leukemia Research Association ; Fresenius-Biotech North America, Inc. ; Gamida Cell Teva Joint Venture Ltd. ; Genentech, Inc. ; Genzyme Corporation ; GlaxoSmithKline ; HistoGenetics, Inc. ; Kiadis Pharma ; The Leukemia \& Lymphoma Society ; The Medical College of Wisconsin ; Merck \& Co, Inc. ; Millennium: The Takeda Oncology Co. ; Milliman USA, Inc. ; Miltenyi Biotec, Inc. ; National Marrow Donor Program ; Optum Healthcare Solutions, Inc. ; Osiris Therapeutics, Inc. ; Otsuka America Pharmaceutical, Inc. ; RemedyMD ; Sanofi ; Seattle Genetics ; Sigma-Tau Pharmaceuticals ; Soligenix, Inc. ; StemCyte, A Global Cord Blood Therapeutics Co. ; Stemsoft Software, Inc. ; Swedish Orphan Biovitrum ; Tarix Pharmaceuticals ; Teva Neuroscience, Inc. ; THERAKOS, Inc. ; and Wellpoint, Inc. ",

year = "2013",

month = may,

doi = "10.1016/j.bbmt.2013.01.004",

language = "English (US)",

volume = "19",

pages = "760--766",

journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

publisher = "Elsevier Inc.",

number = "5",

}

Michaelis, LC, Saad, A, Zhong, X, Le-Rademacher, J, Freytes, CO, Marks, DI, Lazarus, HM, Bird, JM, Holmberg, L, Kamble, RT, Kumar, S, Lill, M, Meehan, KR, Saber, W, Schriber, J, Tay, J, Vogl, DT, Wirk, B, Savani, BN, Gale, RP, Vesole, DH, Schiller, GJ, Abidi, M, Anderson, KC, Nishihori, T, Kalaycio, ME, Vose, JM, Moreb, JS, Drobyski, W, Munker, R, Roy, V, Ghobadi, A, Holland, HK, Nath, R, To, LB, Maiolino, A, Kassim, AA, Giralt, SA, Landau, H, Schouten, HC, Maziarz, RT, Michael, J, Kindwall-Keller, T, Stiff, PJ, Gibson, J, Lonial, S, Krishnan, A, Dispenzieri, A & Hari, P 2013, 'Salvage Second Hematopoietic Cell Transplantation in Myeloma', Biology of Blood and Marrow Transplantation, vol. 19, no. 5, pp. 760-766. https://doi.org/10.1016/j.bbmt.2013.01.004

TY - JOUR

T1 - Salvage Second Hematopoietic Cell Transplantation in Myeloma

AU - Michaelis, Laura C.

AU - Saad, Ayman

AU - Zhong, Xiaobo

AU - Le-Rademacher, Jennifer

AU - Freytes, Cesar O.

AU - Marks, David I.

AU - Lazarus, Hillard M.

AU - Bird, Jennifer M.

AU - Holmberg, Leona

AU - Kamble, Rammurti T.

AU - Kumar, Shaji

AU - Lill, Michael

AU - Meehan, Kenneth R.

AU - Saber, Wael

AU - Schriber, Jeffrey

AU - Tay, Jason

AU - Vogl, Dan T.

AU - Wirk, Baldeep

AU - Savani, Bipin N.

AU - Gale, Robert P.

AU - Vesole, David H.

AU - Schiller, Gary J.

AU - Abidi, Muneer

AU - Anderson, Kenneth C.

AU - Nishihori, Taiga

AU - Kalaycio, Matt E.

AU - Vose, Julie M.

AU - Moreb, Jan S.

AU - Drobyski, William

AU - Munker, Reinhold

AU - Roy, Vivek

AU - Ghobadi, Armin

AU - Holland, H. Kent

AU - Nath, Rajneesh

AU - To, L. Bik

AU - Maiolino, Angelo

AU - Kassim, Adetola A.

AU - Giralt, Sergio A.

AU - Landau, Heather

AU - Schouten, Harry C.

AU - Maziarz, Richard T.

AU - Michael, Joseph

AU - Kindwall-Keller, Tamila

AU - Stiff, Patrick J.

AU - Gibson, John

AU - Lonial, Sagar

AU - Krishnan, Amrita

AU - Dispenzieri, Angela

AU - Hari, Parameswaran

N1 - Funding Information: Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI) , the National Heart, Lung and Blood Institute (NHLBI) , and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI ; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS) ; two grants, N00014-06-1-0704 and N00014-08-1-0058 , from the Office of Naval Research ; and grants from Allos, Inc. ; Amgen, Inc. ; Angioblast; Anonymous donation to the Medical College of Wisconsin ; Ariad ; Be the Match Foundation ; Blue Cross and Blue Shield Association ; Buchanan Family Foundation ; CaridianBCT ; Celgene Corporation ; CellGenix, GmbH ; Children's Leukemia Research Association ; Fresenius-Biotech North America, Inc. ; Gamida Cell Teva Joint Venture Ltd. ; Genentech, Inc. ; Genzyme Corporation ; GlaxoSmithKline ; HistoGenetics, Inc. ; Kiadis Pharma ; The Leukemia & Lymphoma Society ; The Medical College of Wisconsin ; Merck & Co, Inc. ; Millennium: The Takeda Oncology Co. ; Milliman USA, Inc. ; Miltenyi Biotec, Inc. ; National Marrow Donor Program ; Optum Healthcare Solutions, Inc. ; Osiris Therapeutics, Inc. ; Otsuka America Pharmaceutical, Inc. ; RemedyMD ; Sanofi ; Seattle Genetics ; Sigma-Tau Pharmaceuticals ; Soligenix, Inc. ; StemCyte, A Global Cord Blood Therapeutics Co. ; Stemsoft Software, Inc. ; Swedish Orphan Biovitrum ; Tarix Pharmaceuticals ; Teva Neuroscience, Inc. ; THERAKOS, Inc. ; and Wellpoint, Inc.

PY - 2013/5

Y1 - 2013/5

N2 - Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing ≥36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing ≥36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.

AB - Autologous hematopoietic cell transplantation (AHCT) as initial therapy of patients with multiple myeloma (MM) improves survival. However, data to support this approach for relapsed/progressive disease after initial AHCT (AHCT1) are limited. Using Center for International Blood and Marrow Transplant Research data, we report the outcomes of 187 patients who underwent a second AHCT (AHCT2) for the treatment of relapsed/progressive MM. Planned tandem AHCT was excluded. Median age at AHCT2 was 59 years (range, 28 to 72), and median patient follow-up was 47 months (range, 3 to 97). Nonrelapse mortality after AHCT2 was 2% at 1 year and 4% at 3 years. Median interval from AHCT1 to relapse/progression was 18 months, and median interval between transplantations was 32 months. After AHCT2, the incidence of relapse/progression at 1 and 3 years was 51% and 82%, respectively. At 3 years after AHCT2, progression-free survival was 13%, and overall survival was 46%. In multivariate analyses, those relapsing ≥36 months after AHCT1 had superior progression-free (P = .045) and overall survival (P = .019). Patients who underwent AHCT2 after 2004 had superior survival (P = .026). AHCT2 is safe and feasible for disease progression after AHCT1. In this retrospective study, individuals relapsing ≥36 months from AHCT1 derived greater benefit from AHCT2 compared with those with a shorter disease-free interval. Storage of an adequate graft before AHCT1 will ensure that the option of a second autologous transplantation is retained for patients with relapsed/progressive MM.

UR - https://www.scopus.com/pages/publications/84876327529

UR - https://www.scopus.com/pages/publications/84876327529#tab=citedBy

U2 - 10.1016/j.bbmt.2013.01.004

DO - 10.1016/j.bbmt.2013.01.004

M3 - Article

C2 - 23298856

AN - SCOPUS:84876327529

SN - 1083-8791

VL - 19

SP - 760

EP - 766

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 5

ER -

Salvage Second Hematopoietic Cell Transplantation in Myeloma

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