Extramedullary relapses after allogeneic non-myeloablative stem cell transplantation in multiple myeloma patients do not negatively affect treatment outcome
Recent literature suggests that after non-myeloablative allogeneic (NMA) stem cell transplantation (SCT), the incidence of extramedullary (EM) relapse in multiple myeloma (MM) patients is increased and that these relapses have a poor prognosis. However, numbers on incidence and treatment outcome are...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2008-05, Vol.41 (9), p.779-784 |
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| creator | Minnema, M C van de Donk, N W C J Zweegman, S Hegenbart, U Schonland, S Raymakers, R Zijlmans, J M J M Kersten, M J Bos, G M J Lokhorst, H M |
| description | Recent literature suggests that after non-myeloablative allogeneic (NMA) stem cell transplantation (SCT), the incidence of extramedullary (EM) relapse in multiple myeloma (MM) patients is increased and that these relapses have a poor prognosis. However, numbers on incidence and treatment outcome are scarce. We collected data from 54 relapsed MM patients from a total group of 172 treated with sequential autologous and allogeneic NMA SCT at seven transplantation centres. There were 43 (79.6%) systemic relapses, including 6 with concurrent EM localisation. Five patients had a local EM relapse only. Six patients relapsed with only bone involvement. Patients with deletion of chromosome 13 had a higher incidence of EM relapse (30.8 versus 5.6%,
P
=0.06). EM relapses were treated with donor lymphocyte infusion, radiotherapy, or chemotherapy, especially with novel agents. The response rate was 45.5%, which was not different when compared to patients without EM disease (54.1%). Overall survival and progression-free survival were not significantly different in patients with EM disease, when compared to those without EM disease. In conclusion, the incidence of relapse with EM disease following allogeneic NMA SCT was 20.4%. There was no negative impact of EM relapse on response rate, overall survival and progression-free survival. |
| doi_str_mv | 10.1038/sj.bmt.1705982 |
| format | Article |
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P
=0.06). EM relapses were treated with donor lymphocyte infusion, radiotherapy, or chemotherapy, especially with novel agents. The response rate was 45.5%, which was not different when compared to patients without EM disease (54.1%). Overall survival and progression-free survival were not significantly different in patients with EM disease, when compared to those without EM disease. In conclusion, the incidence of relapse with EM disease following allogeneic NMA SCT was 20.4%. There was no negative impact of EM relapse on response rate, overall survival and progression-free survival.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1705982</identifier><identifier>PMID: 18195681</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Autografts ; Biological and medical sciences ; Bone marrow ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Care and treatment ; Cell Biology ; Chemotherapy ; Chromosome 13 ; Chromosome Deletion ; Chromosomes, Human, Pair 13 - genetics ; Diagnosis ; Disease-Free Survival ; Female ; Health aspects ; Hematology ; Homografts ; Humans ; Immunodeficiencies. Immunoglobulinopathies ; Immunoglobulinopathies ; Immunopathology ; Internal Medicine ; Living Donors ; Lymphocyte Transfusion ; Lymphocytes ; Male ; Medical prognosis ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Multiple myeloma ; Multiple Myeloma - genetics ; Multiple Myeloma - mortality ; Multiple Myeloma - prevention & control ; original-article ; Patients ; Public Health ; Radiation therapy ; Recurrence ; Response rates ; Stem Cell Transplantation ; Stem Cells ; Survival ; Survival Rate ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation, Autologous ; Transplantation, Homologous</subject><ispartof>Bone marrow transplantation (Basingstoke), 2008-05, Vol.41 (9), p.779-784</ispartof><rights>Springer Nature Limited 2008</rights><rights>2008 INIST-CNRS</rights><rights>COPYRIGHT 2008 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group May 2008</rights><rights>Nature Publishing Group 2008.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c587t-c7a73cd64c1aab8cebd03525a3542f5e2a9d97505b8feb11fe3b562e127a49923</citedby><cites>FETCH-LOGICAL-c587t-c7a73cd64c1aab8cebd03525a3542f5e2a9d97505b8feb11fe3b562e127a49923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sj.bmt.1705982$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sj.bmt.1705982$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20375665$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18195681$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Minnema, M C</creatorcontrib><creatorcontrib>van de Donk, N W C J</creatorcontrib><creatorcontrib>Zweegman, S</creatorcontrib><creatorcontrib>Hegenbart, U</creatorcontrib><creatorcontrib>Schonland, S</creatorcontrib><creatorcontrib>Raymakers, R</creatorcontrib><creatorcontrib>Zijlmans, J M J M</creatorcontrib><creatorcontrib>Kersten, M J</creatorcontrib><creatorcontrib>Bos, G M J</creatorcontrib><creatorcontrib>Lokhorst, H M</creatorcontrib><title>Extramedullary relapses after allogeneic non-myeloablative stem cell transplantation in multiple myeloma patients do not negatively affect treatment outcome</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>Recent literature suggests that after non-myeloablative allogeneic (NMA) stem cell transplantation (SCT), the incidence of extramedullary (EM) relapse in multiple myeloma (MM) patients is increased and that these relapses have a poor prognosis. However, numbers on incidence and treatment outcome are scarce. We collected data from 54 relapsed MM patients from a total group of 172 treated with sequential autologous and allogeneic NMA SCT at seven transplantation centres. There were 43 (79.6%) systemic relapses, including 6 with concurrent EM localisation. Five patients had a local EM relapse only. Six patients relapsed with only bone involvement. Patients with deletion of chromosome 13 had a higher incidence of EM relapse (30.8 versus 5.6%,
P
=0.06). EM relapses were treated with donor lymphocyte infusion, radiotherapy, or chemotherapy, especially with novel agents. The response rate was 45.5%, which was not different when compared to patients without EM disease (54.1%). Overall survival and progression-free survival were not significantly different in patients with EM disease, when compared to those without EM disease. In conclusion, the incidence of relapse with EM disease following allogeneic NMA SCT was 20.4%. There was no negative impact of EM relapse on response rate, overall survival and progression-free survival.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Autografts</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Care and treatment</subject><subject>Cell Biology</subject><subject>Chemotherapy</subject><subject>Chromosome 13</subject><subject>Chromosome Deletion</subject><subject>Chromosomes, Human, Pair 13 - genetics</subject><subject>Diagnosis</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hematology</subject><subject>Homografts</subject><subject>Humans</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Internal Medicine</subject><subject>Living Donors</subject><subject>Lymphocyte Transfusion</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - genetics</subject><subject>Multiple Myeloma - mortality</subject><subject>Multiple Myeloma - prevention & control</subject><subject>original-article</subject><subject>Patients</subject><subject>Public Health</subject><subject>Radiation therapy</subject><subject>Recurrence</subject><subject>Response rates</subject><subject>Stem Cell Transplantation</subject><subject>Stem Cells</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Transplantation</subject><subject>Transplantation, Autologous</subject><subject>Transplantation, Homologous</subject><issn>0268-3369</issn><issn>1476-5365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkktv1DAUhSMEokNhyxJZILrL1O_Ey6oqD6kSG1hHjnMzzcixQ-xUzH_hx3KnHTGAWmEvLPl-91wd-xTFa0bXjIr6PG3X7ZjXrKLK1PxJsWKy0qUSWj0tVpTruhRCm5PiRUpbSpmUVD0vTljNjNI1WxU_r37k2Y7QLd7beUdm8HZKkIjtM8zEeh83EGBwJMRQjjvw0bbe5uEWSMowEgfeE5QIafI2ZKzEQIZAxsXnYfJA7npGSyYsQciJdBG1MgmwuZPxO5zVg8uoAjaPyJC4ZBdHeFk8661P8OpwnhbfPlx9vfxUXn_5-Pny4rp0qq5y6SpbCddp6Zi1be2g7ahQXFmhJO8VcGs6Uymq2rqHlrEeRKs0B8YrK43h4rQ4u9ed5vh9gZSbcUh7YzZAXFJT0UrgYv8FOdW1kUYj-O4fcBuXOaCJhmvJuRTMSKTePkoxrVUtanmU2lgPzRD6iK_t9nObC1YZJiQ1FKn1AxTuDsbBxQD9gPd_NZz90XAD1uebFP2y_7_0oLKbY0oz9M00DyNmpWG02WewSdsGM9gcMogNbw6ulhaDdcQPoUPg_QGwyVnfY3jckH5znIpKoXvkzu-5hKWwgfn4PI-M_gXvi_ZV</recordid><startdate>20080501</startdate><enddate>20080501</enddate><creator>Minnema, M C</creator><creator>van de Donk, N W C J</creator><creator>Zweegman, S</creator><creator>Hegenbart, U</creator><creator>Schonland, S</creator><creator>Raymakers, R</creator><creator>Zijlmans, J M J M</creator><creator>Kersten, M J</creator><creator>Bos, G M J</creator><creator>Lokhorst, H M</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20080501</creationdate><title>Extramedullary relapses after allogeneic non-myeloablative stem cell transplantation in multiple myeloma patients do not negatively affect treatment outcome</title><author>Minnema, M C ; van de Donk, N W C J ; Zweegman, S ; Hegenbart, U ; Schonland, S ; Raymakers, R ; Zijlmans, J M J M ; Kersten, M J ; Bos, G M J ; Lokhorst, H M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c587t-c7a73cd64c1aab8cebd03525a3542f5e2a9d97505b8feb11fe3b562e127a49923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Autografts</topic><topic>Biological and medical sciences</topic><topic>Bone marrow</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Care and treatment</topic><topic>Cell Biology</topic><topic>Chemotherapy</topic><topic>Chromosome 13</topic><topic>Chromosome Deletion</topic><topic>Chromosomes, Human, Pair 13 - genetics</topic><topic>Diagnosis</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hematology</topic><topic>Homografts</topic><topic>Humans</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Internal Medicine</topic><topic>Living Donors</topic><topic>Lymphocyte Transfusion</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multiple myeloma</topic><topic>Multiple Myeloma - genetics</topic><topic>Multiple Myeloma - mortality</topic><topic>Multiple Myeloma - prevention & control</topic><topic>original-article</topic><topic>Patients</topic><topic>Public Health</topic><topic>Radiation therapy</topic><topic>Recurrence</topic><topic>Response rates</topic><topic>Stem Cell Transplantation</topic><topic>Stem Cells</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation</topic><topic>Transplantation, Autologous</topic><topic>Transplantation, Homologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Minnema, M C</creatorcontrib><creatorcontrib>van de Donk, N W C J</creatorcontrib><creatorcontrib>Zweegman, S</creatorcontrib><creatorcontrib>Hegenbart, U</creatorcontrib><creatorcontrib>Schonland, S</creatorcontrib><creatorcontrib>Raymakers, R</creatorcontrib><creatorcontrib>Zijlmans, J M J M</creatorcontrib><creatorcontrib>Kersten, M J</creatorcontrib><creatorcontrib>Bos, G M J</creatorcontrib><creatorcontrib>Lokhorst, H M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Bone marrow transplantation (Basingstoke)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Minnema, M C</au><au>van de Donk, N W C J</au><au>Zweegman, S</au><au>Hegenbart, U</au><au>Schonland, S</au><au>Raymakers, R</au><au>Zijlmans, J M J M</au><au>Kersten, M J</au><au>Bos, G M J</au><au>Lokhorst, H M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extramedullary relapses after allogeneic non-myeloablative stem cell transplantation in multiple myeloma patients do not negatively affect treatment outcome</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><stitle>Bone Marrow Transplant</stitle><addtitle>Bone Marrow Transplant</addtitle><date>2008-05-01</date><risdate>2008</risdate><volume>41</volume><issue>9</issue><spage>779</spage><epage>784</epage><pages>779-784</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>Recent literature suggests that after non-myeloablative allogeneic (NMA) stem cell transplantation (SCT), the incidence of extramedullary (EM) relapse in multiple myeloma (MM) patients is increased and that these relapses have a poor prognosis. However, numbers on incidence and treatment outcome are scarce. We collected data from 54 relapsed MM patients from a total group of 172 treated with sequential autologous and allogeneic NMA SCT at seven transplantation centres. There were 43 (79.6%) systemic relapses, including 6 with concurrent EM localisation. Five patients had a local EM relapse only. Six patients relapsed with only bone involvement. Patients with deletion of chromosome 13 had a higher incidence of EM relapse (30.8 versus 5.6%,
P
=0.06). EM relapses were treated with donor lymphocyte infusion, radiotherapy, or chemotherapy, especially with novel agents. The response rate was 45.5%, which was not different when compared to patients without EM disease (54.1%). Overall survival and progression-free survival were not significantly different in patients with EM disease, when compared to those without EM disease. In conclusion, the incidence of relapse with EM disease following allogeneic NMA SCT was 20.4%. There was no negative impact of EM relapse on response rate, overall survival and progression-free survival.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>18195681</pmid><doi>10.1038/sj.bmt.1705982</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0268-3369 |
| ispartof | Bone marrow transplantation (Basingstoke), 2008-05, Vol.41 (9), p.779-784 |
| issn | 0268-3369 1476-5365 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals; Nature Journals Online; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Autografts Biological and medical sciences Bone marrow Bone marrow, stem cells transplantation. Graft versus host reaction Care and treatment Cell Biology Chemotherapy Chromosome 13 Chromosome Deletion Chromosomes, Human, Pair 13 - genetics Diagnosis Disease-Free Survival Female Health aspects Hematology Homografts Humans Immunodeficiencies. Immunoglobulinopathies Immunoglobulinopathies Immunopathology Internal Medicine Living Donors Lymphocyte Transfusion Lymphocytes Male Medical prognosis Medical sciences Medicine Medicine & Public Health Middle Aged Multiple myeloma Multiple Myeloma - genetics Multiple Myeloma - mortality Multiple Myeloma - prevention & control original-article Patients Public Health Radiation therapy Recurrence Response rates Stem Cell Transplantation Stem Cells Survival Survival Rate Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Transplantation, Autologous Transplantation, Homologous |
| title | Extramedullary relapses after allogeneic non-myeloablative stem cell transplantation in multiple myeloma patients do not negatively affect treatment outcome |
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