Second autologous transplant as salvage therapy in multiple myeloma

Atanackovic, Djordje; Schilling, Georgia

doi:10.1111/bjh.12579

Cited by 39 publications

(30 citation statements)

References 52 publications

(95 reference statements)

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“…If the response duration after the initial transplant was less than 1 year, stem cell transplantation could not be recommended as an effective intervention. 87 Currently at Mayo, we routinely collect sufficient stem cells for 2 transplants but do not perform tandem transplantations; we keep an aliquot cryopreserved for a second transplant at relapse.…”

Section: Plerixafor Dosingmentioning

confidence: 99%

How we manage autologous stem cell transplantation for patients with multiple myeloma

Gertz¹,

Dingli

2014

Blood

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An estimated 22 350 patients had multiple myeloma diagnosed in 2013, representing 1.3% of all new cancers; 10 710 deaths are projected, representing 1.8% of cancer deaths. Approximately 0.7% of US men and women will have a myeloma diagnosis in their lifetime, and with advances in therapy, 77 600 US patients are living with myeloma. The 5-year survival rate was 25.6% in 1989 and was 44.9% in 2005. The median age at diagnosis is 69 years, with 62.4% of patients aged 65 or older at diagnosis. Median age at death is 75 years. The rate of new myeloma cases has been rising 0.7% per year during the past decade. The most common indication for autologous stem cell transplantation in the United States is multiple myeloma, and this article is designed to provide the specifics of organizing a transplant program for multiple myeloma. We review the data justifying use of stem cell transplantation as initial management in myeloma patients. We provide selection criteria that minimize the risks of transplantation. Specific guidelines on mobilization and supportive care through the transplant course, as done at Mayo Clinic, are given. A review of the data on tandem vs sequential autologous transplants is provided.

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Section: Plerixafor Dosingmentioning

confidence: 99%

How we manage autologous stem cell transplantation for patients with multiple myeloma

Gertz¹,

Dingli

2014

Blood

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“…Previous retrospective studies have indicated that a second ASCT is beneficial at relapse, at least if relapse occurs later than 18 months from initial treatment. 11 However, the development of novel drugs, for example, PI and IMiDs 1,[12][13][14][15] have raised the question if a second ASCT could be replaced by these drugs in second line. [16][17][18] A recent prospective study has shown that HDT followed by ASCT is superior to a cyclophosphamide-based regimen but data are lacking for comparing the novel drugs to ASCT.…”

Section: Introductionmentioning

confidence: 99%

Autologous stem cell transplantation versus novel drugs or conventional chemotherapy for patients with relapsed multiple myeloma after previous ASCT

Grövdal

Nahi

Gahrton

et al. 2015

Bone Marrow Transplant

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High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is the most common first-line treatment for patients with multiple myeloma (MM) under 65 years of age. A second ASCT at first relapse is frequently used but is challenged by the use of novel drugs. We retrospectively studied the outcome of second-line treatment in MM patients from the Nordic countries with relapse after first-line HDT and ASCT. Patients that underwent a second ASCT (n = 111) were compared with patients re-treated with conventional cytotoxic drugs only (n = 91) or with regimens including novel drugs (proteasome inhibitors and/or immunomodulatory drugs) (n = 362) without a second ASCT. For patients receiving a second ASCT median overall survival was 4.0 years compared with 3.3 years (P o 0.001) for the group treated with novel drugs and 2.5 years (P o 0.001) for those receiving conventional cytotoxic drugs only. A second ASCT also resulted in a significantly longer second time to progression and a significantly longer time to next treatment. We conclude that, irrespective of the addition of novel drugs, MM patients in first relapse after ASCT still appear to benefit from a second ASCT. A second ASCT should be considered for all physically fit patients.

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“…The predictor historically associated with worse TTP after salvage auto-SCT is the response duration after the first auto-SCT. [25] Alvares et al confirmed this finding in 83 patients treated with a salvage second auto-SCT. Twenty patients had relapsed within 18 months from the first auto-SCT.…”

Section: Treatment Of Post Auto-sct Relapsementioning

confidence: 78%

Stem cell transplantation in multiple myeloma and other plasma cell disorders (report from an EBMT preceptorship meeting)

Bruno

Auner

Gahrton

et al. 2016

Leukemia & Lymphoma

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The definitive version is available at: La versione definitiva è disponibile alla URL: [http://www.tandfonline.com.offcampus.dam.unito.it/doi/full/10.3109/10428194.2015.1131278] Stem cell transplantation in multiple myeloma and other plasma cell disorders (report from an EBMT preceptorship meeting) AbstractThe European Society for Blood and Marrow Transplantation Chronic Malignancies Working Party held a preceptorship meeting in Turin, Italy on 25-26 September 2014, to discuss the role of stem cell transplantation (SCT) in the treatment of multiple myeloma and other plasma cell disorders. Scientists and clinicians working in the field gathered to discuss a variety of topics including the results of recent clinical trials, basic research, the concept of minimal residual disease, and immune modulation. As individual presentations revealed, important advances have occurred in our understanding of the pathophysiology of myeloma and the role that SCT, along with other forms of immunotherapy, plays in treating it. Each presentation stimulated discussion and exchange of ideas among the attendants. We decided to summarize and, importantly, to update the meeting proceedings in this review to share stimulating discussions and ideas on potentially novel treatment strategies among clinicians.

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Second autologous transplant as salvage therapy in multiple myeloma

Cited by 39 publications

References 52 publications

How we manage autologous stem cell transplantation for patients with multiple myeloma

How we manage autologous stem cell transplantation for patients with multiple myeloma

Autologous stem cell transplantation versus novel drugs or conventional chemotherapy for patients with relapsed multiple myeloma after previous ASCT

Stem cell transplantation in multiple myeloma and other plasma cell disorders (report from an EBMT preceptorship meeting)

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