Alemtuzumab-Based Reduced-Intensity Conditioning Allogeneic Transplantation for Myeloma and Plasma Cell Leukemia - A Single-Institution Experience

TY - JOUR

T1 - Alemtuzumab-Based Reduced-Intensity Conditioning Allogeneic Transplantation for Myeloma and Plasma Cell Leukemia - A Single-Institution Experience

AU - Ramasamy, Karthik

AU - Mahmood, Shameem

AU - Lim, ZiYi

AU - Corderoy, Sophie

AU - Devereux, Stephen

AU - Mufti, Ghulam J.

AU - Pagliuca, Antonio

AU - Schey, Stephen

PY - 2011/4

Y1 - 2011/4

N2 - Background: Reduced-intensity conditioning allogeneic transplantation for myeloma is associated with lower non-relapse mortality and higher relapse rates in comparison with myeloablative conditioning transplants. Patients and Methods: We have retrospectively audited 19 patients with myeloma or primary plasma cell leukemia who received allogeneic transplantation with a uniform alemtuzumab-based reduced-intensity conditioning protocol. These patients had not been treated with bortezomib or lenalidomide before transplantation. Results: The treatment-related mortality at 1 year was (4/19) 21% with low incidence of graft-versus-host disease (6%) and 2-year progression-free survival and overall survival rates of 35% and 42%, respectively. Conclusion: Progression-free survival in this cohort of patients is comparable to previously published data of reduced-intensity conditioning allogeneic transplantation in myeloma. However, there is no plateau observed on the survival curves with a significant transplant-related mortality of 21%. Therefore, alemtuzumab-based allogeneic transplantation cannot be recommended as standard practice outside of clinical trials for treatment of myeloma.

AB - Background: Reduced-intensity conditioning allogeneic transplantation for myeloma is associated with lower non-relapse mortality and higher relapse rates in comparison with myeloablative conditioning transplants. Patients and Methods: We have retrospectively audited 19 patients with myeloma or primary plasma cell leukemia who received allogeneic transplantation with a uniform alemtuzumab-based reduced-intensity conditioning protocol. These patients had not been treated with bortezomib or lenalidomide before transplantation. Results: The treatment-related mortality at 1 year was (4/19) 21% with low incidence of graft-versus-host disease (6%) and 2-year progression-free survival and overall survival rates of 35% and 42%, respectively. Conclusion: Progression-free survival in this cohort of patients is comparable to previously published data of reduced-intensity conditioning allogeneic transplantation in myeloma. However, there is no plateau observed on the survival curves with a significant transplant-related mortality of 21%. Therefore, alemtuzumab-based allogeneic transplantation cannot be recommended as standard practice outside of clinical trials for treatment of myeloma.

U2 - 10.1016/j.dml.2011.03.004

DO - 10.1016/j.dml.2011.03.004

M3 - Article

VL - 11

SP - 242

EP - 245

JO - Clinical Lymphoma Myeloma & Leukemia

JF - Clinical Lymphoma Myeloma & Leukemia

IS - 2

ER -