Tandem Autologous/Allogeneic Transplant for Myeloma: Long-Term Follow-up of CALGB 100001
Posted: Wednesday, June 3, 2020
The CALGB (Alliance) 10001 study, published in Biology of Blood and Marrow Transplantation, has found that autologous stem cell transplant (autoSCT) followed by nonmyeloablative allogeneic stem cell transplant (alloSCT) may result in durable disease control for some patients with multiple myeloma. The phase II study, conducted by Sarah A. Holstein, MD, PhD, of the University of Nebraska Medical Center, Omaha, and colleagues, focused on patients who had received up to 18 months of prior therapy.
A total of 60 patients were enrolled in the study; 95% (n = 57) completed 200 mg/m2 of melphalan for autoSCT and 82% (n = 49) of whom completed autoSCT plus 30 mg/m2 of intravenous fludarabine on days –7 through –3 and 1 g/m2 of intravenous cyclophosphamide on days –4 through –3 for alloSCT. At a median follow-up of 11 years, the median overall survival was 6.6 years, and the median time to disease progression was 3.6 years.
Among patients completing tandem autoSCT/alloSCT, the treatment-related mortality rate was 2%, with one patient dying as a result of graft-versus-host disease within 9 months of alloSCT. A total of 27% of patients experienced grade 2 or 3 graft-versus-host disease—the same number who indicated that graft-versus-host disease persisted in the year following alloSCT to either a limited (31%) or an extensive (24%) degree.
“This study demonstrated the feasibility of performing tandem autoSCT/alloSCT in a cooperative group setting and determined that a fludarabine/cyclophosphamide [reduced-intensity conditioning] regimen is associated with a very low [treatment-related mortality] rate,” concluded the investigators.
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
