Allogeneic hematopoietic cell transplantation (HCT) using post-transplant cyclophosphamide (PTCy) can be safely performed in patients with multiple myeloma (MM), resulting in low rates of both acute and chronic graft-versus-host disease (GVHD) and rates of non-relapse mortality (NRM). These results compare favorably to those seen in patients with other hematologic malignancies.
This retrospective, single-center study of 39 adults with a median age of 54 years (range 36-70) analyzed outcomes in patients with MM transplanted between 2003 and 2011 using HLA-matched related/unrelated or haploidentical related donors. Post-transplant cyclophosphamide was given with or without mycophenolate mofetil and tacrolimus.
The cumulative incidence of acute grade II-IV and grade III-IV GVHD was 41% and 8%, respectively for patients who achieved engraftment. No patients developed grade IV acute GVHD. The cumulative incidence of chronic GVHD was 13%. Non-relapse mortality occurred in only one patient.
The median overall survival was 4.4 years and the 5- and 10-year overall survival probabilities were 49% and 43%, respectively.
The researchers concluded that the use of PTCy in adults with MM is feasible and results in low NRM and GVHD rates, and noted that “the safety of this approach may allow the development of novel post-transplant maintenance strategies to improve long-term disease control.”