Long-term outcomes of allogeneic stem cell transplant in multiple myeloma

Walker M. Schmidt; Nirosha D. Perera; Francis K. Buadi; Suzanne R. Hayman; Shaji K. Kumar; Angela Dispenzieri; David Dingli; Joselle Cook; Martha Q. Lacy; Prashant Kapoor; Nelson Leung; Eli Muchtar; Rahma M. Warsame; Taxiarchis Kourelis; Moritz Binder; Wilson I. Gonsalves; William J. Hogan; Morie A. Gertz

doi:10.1038/s41408-023-00900-z

Long-term outcomes of allogeneic stem cell transplant in multiple myeloma

Walker M. Schmidt, Nirosha D. Perera, Francis K. Buadi, Suzanne R. Hayman, Shaji K. Kumar, Angela Dispenzieri, David Dingli, Joselle Cook, Martha Q. Lacy, Prashant Kapoor, Nelson Leung, Eli Muchtar, Rahma M. Warsame, Taxiarchis Kourelis, Moritz Binder, Wilson I. Gonsalves, William J. Hogan, Morie A. Gertz

Hematology

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

Abstract

Allogeneic stem cell transplant (allo SCT) for multiple myeloma (MM) is potentially curative in some, while toxic in many others. We retrospectively analyzed 85 patients diagnosed with MM who underwent allo SCT as frontline or salvage therapy between 2000 and 2022 at Mayo Clinic Rochester and examined patient outcomes and prognostic markers. Overall survival (OS), progression free survival (PFS), treatment related mortality (TRM), and relapse rates (RR) were estimated using the Kaplan Meier method and competing risk models. Median follow-up was 11.5 years. Median OS and PFS were 1.7 and 0.71 years, respectively. Five-year OS and PFS were 22.2% and 15.1%, respectively. One-year TRM was 23.5%. Twelve patients demonstrated durable overall survival, living 10+ years beyond their allo SCT. This subgroup was more likely to have no or one prior auto SCT (p = 0.03) and to have been transplanted between 2000 and 2010 (p = 0.03). Outcomes were poor in this cohort with long follow-up, with few patients surviving 5 years or more, and most relapsing or dying within 2 years. We would expect better outcomes and tolerability with an expanded array of novel therapeutics and would prefer them to allo SCT.

Original language	English (US)
Article number	126
Journal	Blood cancer journal
Volume	13
Issue number	1
DOIs	https://doi.org/10.1038/s41408-023-00900-z
State	Published - Dec 2023

ASJC Scopus subject areas

Hematology
Oncology

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Schmidt, W. M., Perera, N. D., Buadi, F. K., Hayman, S. R., Kumar, S. K., Dispenzieri, A., Dingli, D., Cook, J., Lacy, M. Q., Kapoor, P., Leung, N., Muchtar, E., Warsame, R. M., Kourelis, T., Binder, M., Gonsalves, W. I., Hogan, W. J., & Gertz, M. A. (2023). Long-term outcomes of allogeneic stem cell transplant in multiple myeloma. Blood cancer journal, 13(1), Article 126. https://doi.org/10.1038/s41408-023-00900-z

Schmidt, WM, Perera, ND, Buadi, FK, Hayman, SR, Kumar, SK , Dispenzieri, A , Dingli, D, Cook, J, Lacy, MQ , Kapoor, P, Leung, N, Muchtar, E, Warsame, RM, Kourelis, T, Binder, M, Gonsalves, WI , Hogan, WJ & Gertz, MA 2023, 'Long-term outcomes of allogeneic stem cell transplant in multiple myeloma', Blood cancer journal, vol. 13, no. 1, 126. https://doi.org/10.1038/s41408-023-00900-z

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abstract = "Allogeneic stem cell transplant (allo SCT) for multiple myeloma (MM) is potentially curative in some, while toxic in many others. We retrospectively analyzed 85 patients diagnosed with MM who underwent allo SCT as frontline or salvage therapy between 2000 and 2022 at Mayo Clinic Rochester and examined patient outcomes and prognostic markers. Overall survival (OS), progression free survival (PFS), treatment related mortality (TRM), and relapse rates (RR) were estimated using the Kaplan Meier method and competing risk models. Median follow-up was 11.5 years. Median OS and PFS were 1.7 and 0.71 years, respectively. Five-year OS and PFS were 22.2% and 15.1%, respectively. One-year TRM was 23.5%. Twelve patients demonstrated durable overall survival, living 10+ years beyond their allo SCT. This subgroup was more likely to have no or one prior auto SCT (p = 0.03) and to have been transplanted between 2000 and 2010 (p = 0.03). Outcomes were poor in this cohort with long follow-up, with few patients surviving 5 years or more, and most relapsing or dying within 2 years. We would expect better outcomes and tolerability with an expanded array of novel therapeutics and would prefer them to allo SCT.",

author = "Schmidt, {Walker M.} and Perera, {Nirosha D.} and Buadi, {Francis K.} and Hayman, {Suzanne R.} and Kumar, {Shaji K.} and Angela Dispenzieri and David Dingli and Joselle Cook and Lacy, {Martha Q.} and Prashant Kapoor and Nelson Leung and Eli Muchtar and Warsame, {Rahma M.} and Taxiarchis Kourelis and Moritz Binder and Gonsalves, {Wilson I.} and Hogan, {William J.} and Gertz, {Morie A.}",

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AU - Schmidt, Walker M.

AU - Perera, Nirosha D.

AU - Buadi, Francis K.

AU - Hayman, Suzanne R.

AU - Kumar, Shaji K.

AU - Dispenzieri, Angela

AU - Dingli, David

AU - Cook, Joselle

AU - Lacy, Martha Q.

AU - Kapoor, Prashant

AU - Leung, Nelson

AU - Muchtar, Eli

AU - Warsame, Rahma M.

AU - Kourelis, Taxiarchis

AU - Binder, Moritz

AU - Gonsalves, Wilson I.

AU - Hogan, William J.

AU - Gertz, Morie A.

PY - 2023/12

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N2 - Allogeneic stem cell transplant (allo SCT) for multiple myeloma (MM) is potentially curative in some, while toxic in many others. We retrospectively analyzed 85 patients diagnosed with MM who underwent allo SCT as frontline or salvage therapy between 2000 and 2022 at Mayo Clinic Rochester and examined patient outcomes and prognostic markers. Overall survival (OS), progression free survival (PFS), treatment related mortality (TRM), and relapse rates (RR) were estimated using the Kaplan Meier method and competing risk models. Median follow-up was 11.5 years. Median OS and PFS were 1.7 and 0.71 years, respectively. Five-year OS and PFS were 22.2% and 15.1%, respectively. One-year TRM was 23.5%. Twelve patients demonstrated durable overall survival, living 10+ years beyond their allo SCT. This subgroup was more likely to have no or one prior auto SCT (p = 0.03) and to have been transplanted between 2000 and 2010 (p = 0.03). Outcomes were poor in this cohort with long follow-up, with few patients surviving 5 years or more, and most relapsing or dying within 2 years. We would expect better outcomes and tolerability with an expanded array of novel therapeutics and would prefer them to allo SCT.

AB - Allogeneic stem cell transplant (allo SCT) for multiple myeloma (MM) is potentially curative in some, while toxic in many others. We retrospectively analyzed 85 patients diagnosed with MM who underwent allo SCT as frontline or salvage therapy between 2000 and 2022 at Mayo Clinic Rochester and examined patient outcomes and prognostic markers. Overall survival (OS), progression free survival (PFS), treatment related mortality (TRM), and relapse rates (RR) were estimated using the Kaplan Meier method and competing risk models. Median follow-up was 11.5 years. Median OS and PFS were 1.7 and 0.71 years, respectively. Five-year OS and PFS were 22.2% and 15.1%, respectively. One-year TRM was 23.5%. Twelve patients demonstrated durable overall survival, living 10+ years beyond their allo SCT. This subgroup was more likely to have no or one prior auto SCT (p = 0.03) and to have been transplanted between 2000 and 2010 (p = 0.03). Outcomes were poor in this cohort with long follow-up, with few patients surviving 5 years or more, and most relapsing or dying within 2 years. We would expect better outcomes and tolerability with an expanded array of novel therapeutics and would prefer them to allo SCT.

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Long-term outcomes of allogeneic stem cell transplant in multiple myeloma

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