Autologous-allogeneic versus autologous tandem stem cell transplantation and maintenance therapy with thalidomide for multiple myeloma patients less than 60 years of age: a prospective phase II study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Nicolaus Kröger - , University Hospital Hamburg Eppendorf (Author)
  • Gerald Wulf - , University Medical Center Göttingen (Author)
  • Ute Hegenbart - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Andreas Burchert - , University Hospital Gießen and Marburg (Author)
  • Matthias Stelljes - , University Hospital Münster (Author)
  • Nico Gagelmann - , University Hospital Hamburg Eppendorf (Author)
  • Arne Brecht - , DKD Helios Klinik Wiesbaden (Author)
  • Martin Kaufmann - , Robert Bosch Krankenhaus Stuttgart (Author)
  • Lutz Müller - , Martin Luther University Hospital (Author)
  • Arnold Ganser - , Hannover Medical School (MHH) (Author)
  • Dominik Wolf - , University of Bonn Medical Center (Author)
  • Wolfgang Bethge - , University Hospital Tübingen (Author)
  • Martin Bornhäuser - , Department of internal Medicine I (Author)
  • Michael Kiehl - , Klinikum Frankfurt (Oder) (Author)
  • Eva-Maria Wagner - , University Medical Center Mainz (Author)
  • Christoph Schmid - , University Hospital Augsburg (Author)
  • Hans Christian Reinhardt - , University Hospital Essen (Author)
  • Guido Kobbe - , University Hospital Duesseldorf (Author)
  • Hans Salwender - , Asklepios Clinic Altona (Author)
  • Thomas Heinicke - , University Hospital Magdeburg (Author)
  • Martin Kropff - , Hospital Osnabrück (Author)
  • Marion Heinzelmann - , University Hospital Hamburg Eppendorf (Author)
  • Francis Ayuk - , University Hospital Hamburg Eppendorf (Author)
  • Lorenz Trümper - , University Medical Center Göttingen (Author)
  • Andreas Neubauer - , University Hospital Gießen and Marburg (Author)
  • Andreas Völp - , Psy Consult (Author)
  • Evgeny Kluychnikov - , University Hospital Hamburg Eppendorf (Author)
  • Stefan Schönland - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Christine Wolschke - , University Hospital Hamburg Eppendorf (Author)

Abstract

The role of autologous-allogeneic tandem stem cell transplantation (alloTSCT) followed by maintenance as upfront treatment for multiple myeloma (MM) is controversial. Between 2008 and 2014 a total of 217 MM patients with a median age of 51 years were included by 20 German centers within an open-label, parallel-group, multi-center clinical trial to compare alloTSCT to auto tandem transplantation TSCT (autoTSCT) followed by a 2-year maintenance therapy with thalidomide (100 mg/d) in both arms with respect to relapse/progression-free survival (PFS) and other relevant outcomes. A total of 178 patients underwent second SCT (allo n = 132 and auto n = 46). PFS at 4 years after the second SCT was 47% (CI: 38-55%) for alloTSCT and 35% (CI: 21-49%) for autoTSCT (p = 0.26). This difference increased to 22% at 8 years (p = 0.10). The cumulative incidences of non-relapse mortality (NRM) and of relapse at 4 years were 13% (CI: 8-20%) and 2% (CI: 0.3-2%) (p = 0.044) and 40% (CI: 33-50%) and 63% (CI: 50-79%) for alloTSCT and autoTSCT (p = 0.04), respectively. The difference for relapse/progression increased to 33% (alloTSCT: 44%, autoTSCT: 77%) at a median follow-up of 82 months (p = 0.002). Four-year OS was 66% (CI: 57-73%) for alloTSCT and 66% (CI: 50-78%) for auto TSCT (p = 0.91) and 8-year OS was 52% and 50% (p = 0.87), respectively. AlloTSCT followed by thalidomide maintenance reduced the rate of recurrence or progression during a follow-up period of up to 10 years but failed to improve PFS significantly.

Details

Original languageEnglish
JournalHaematologica
Publication statusE-pub ahead of print - 9 Nov 2023
Peer-reviewedYes

External IDs

unpaywall 10.3324/haematol.2023.282920
Scopus 85192035780

Keywords