Allogeneic Hematopoietic Cell Transplantation for Multiple Myeloma in Europe: Trends and Outcomes Over 25 Years. A Study by the EBMT CMWP
We describe the use and outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for multiple myeloma (MM) in Europe between January 1990 and December 2012. We identified 7333 patients, median age at allo-HSCT was 51 years (range: 18–78), 4539 (62%) were males. We distinguished three groups: 1) allo-HSCT upfront (n=1924), 2) tandem auto-allo-HSCT (n=2004) and 3) allo-HSCT as second line treatment and beyond (n=3405). Overall, there is a steady increase in numbers of allo-HSCT over the years. Upfront allo-HSCT use increased up to year 2000, followed by a decrease thereafter and represented 12% of allo-HSCTs performed in 2012. Tandem auto-allo-HSCT peaked around year 2004 and contributed to 19% of allo-HSCTs in 2012. Allo-HSCT as salvage after 1/2/3 autografts was steadily increasing over the last years and represented 69% of allo-HSCTs in 2012. Remarkable heterogeneity in using allo-HSCT was observed among the different European countries. The 5-years survival probabilities from time of allo-HSCT for the three groups after year 2004 were 42, 54 and 32% respectively. These results show that the use of allo-HSCT is increasing in Europe, especially as second line treatment and beyond. There is an unmet need for well-designed prospective studies investigating allo-HSCT as salvage therapy for MM.
Leukemia