Table 1.
Patient, disease, and transplant characteristics
| Characteristics | Overall | Upfront-allo | Auto-allo | Relapse | P | Missing |
|---|---|---|---|---|---|---|
| N (%) | 205 (100) | 75 (37) | 74 (36) | 56 (27) | ||
| Age, years, median (range) | 51.7 (26.3–66.1) | 47.4 (26.3–59.7) | 53.2 (30.7–65.1) | 56.1 (41.9–66.1) | < 0.001 | |
| < 50 | 83 (40) | 47 (63) | 24 (32) | 12 (21) | ||
| 50–60 | 98 (48) | 28 (37) | 42 (57) | 28 (50) | ||
| > 60 | 24 (12) | 0 (0) | 8 (11) | 16 (29) | ||
| Gender male/female | 105/100 (51/49) | 42/33 (56/44) | 34/40 (46/54) | 29/27 (52/48) | 0.468 | |
| Myeloma subtype | 0.092 | |||||
| IgG | 121 (59) | 45 (60) | 47 (64) | 29 (52) | ||
| IgA | 33 (16) | 8 (11) | 9 (12) | 16 (28) | ||
| IgD | 5 (2) | 4 (5) | 1 (1) | 0 (0) | ||
| Light chain | 43 (21) | 17 (23) | 15 (20) | 11 (20) | ||
| Nonsecretory | 3 (2) | 1 (1) | 2 (3) | 0 (0) | ||
| ISS stage | 0.385 | 30 (14) | ||||
| I | 71 (35) | 31 (41) | 21 (28) | 19 (34) | ||
| II | 69 (34) | 22 (29) | 31 (42) | 16 (29) | ||
| III | 35 (17) | 13 (17) | 15 (20) | 7 (13) | ||
| Cytogenetic risk | 0.054 | 118 (58) | ||||
| Standard | 56 (27) | 30 (40) | 13 (18) | 13 (23) | ||
| Higha | 31 (15) | 9 (12) | 14 (19) | 8 (14) | ||
| Extramedullary diseaseb | 63 (31) | 35 (47) | 13 (18) | 15 (27) | 0.001 | 7 (3) |
| Number of pre-allo-SCT treatment lines | < 0.001 | 1 | ||||
| 1 | 74 (36) | 31 (41) | 43 (58) | 0 (0) | ||
| 2 | 67 (33) | 25 (33) | 23 (31) | 19 (34) | ||
| 3 | 44 (22) | 14 (19) | 7 (10) | 23 (42) | ||
| ≥ 4 | 19 (9) | 5 (7) | 1 (1) | 13 (23) | ||
| Induction treatment | < 0.001 | 1 | ||||
| AD/VAD | 79 (39) | 17 (23) | 40 (54) | 22 (39) | ||
| VCD | 46 (23) | 19 (25) | 21 (28) | 6 (11) | ||
| BorDex | 27 (13) | 11 (15) | 5 (7) | 11 (20) | ||
| Thalidomide-based combination | 27 (13) | 16 (21) | 2 (3) | 9 (16) | ||
| RVD | 13 (6) | 6 (8) | 3 (4) | 4 (7) | ||
| MP | 2 (1) | 0 (0) | 0 (0) | 2 (4) | ||
| Otherc | 10 (5) | 6 (8) | 3 (4) | 1 (2) | ||
| Novel drugs prior to allo-SCT | < 0.001 | |||||
| IMID | 110 (54) | 44 (59) | 22 (30) | 44 (79) | ||
| PI | 128 (62) | 55 (73) | 37 (50) | 36 (64) | ||
| IMID and PI | 82 (40) | 35 (47) | 18 (24) | 29 (52) | ||
| None | 49 (24) | 11 (15) | 33 (45) | 5 (9) | ||
| Disease status prior to allo-SCT | 0.093 | 1 | ||||
| sCR/CR | 42 (20) | 10 (14) | 22 (30) | 10 (18) | ||
| VGPR/PR | 149 (73) | 60 (80) | 49 (66) | 40 (71) | ||
| MR/SD | 3 (1) | 1 (1) | 0 (0) | 2 (4) | ||
| PD | 10 (5) | 4 (5) | 2 (3) | 4 (7) | ||
| Time between diagnosis and 1st auto-SCT, days, median (range) | 206 (113–2643) | 195 (119–2643) | 219 (113–2300) | 0.092 | ||
| Time between last auto-SCT and allo-SCT, days, median (range)d | 205 (63–4459) | 161 (63–391) | 750 (113–4459) | < 0.001 | ||
| Time between diagnosis and allo-SCT, days, median (range) | 377 (137–5104) | 261 (137–1721) | 372 (218–2776) | 1145 (246–5104) | < 0.001 | |
| Karnofsky performance status ≥ 80 | 199 (97) | 70 (93) | 73 (99) | 56 (100) | 0.192 | 1 |
| Donor source | 0.030 | |||||
| Sibling | 100 (49) | 33 (44) | 45 (61) | 22 (39) | ||
| HLA matched | 99 (48) | 33 (44) | 45 (61) | 21 (38) | ||
| 9/10 HLA matched | 1 (1) | 0 (0) | 0 (0) | 1 (1) | ||
| MUD | 105 (51) | 42 (56) | 29 (39) | 34 (61) | ||
| 10/10 HLA matched | 89 (43) | 34 (45) | 23 (31) | 32 (57) | ||
| ≤ 9/10 HLA matched | 16 (8) | 8 (11) | 6 (8) | 2 (4) | ||
| Donor/recipient gender | 0.520 | |||||
| M/M | 73 (36) | 32 (43) | 24 (32) | 17 (30) | ||
| M/F | 52 (25) | 15 (20) | 23 (31) | 14 (25) | ||
| F/M | 32 (16) | 10 (13) | 10 (14) | 12 (22) | ||
| F/F | 48 (23) | 18 (24) | 17 (23) | 13 (23) | ||
| Graft type | < 0.001 | |||||
| BM | 39 (19) | 28 (37) | 4 (5) | 7 (12) | ||
| PB | 166 (81) | 47 (63) | 70 (95) | 49 (88) | ||
| Conditioning regimen | < 0.001 | |||||
| MACe | 88 (43) | 73 (97) | 4 (5) | 11 (20) | ||
| CyTBI | 55 (27) | 53 (70) | 0 (0) | 2 (4) | ||
| Treo14 | 33 (16) | 20 (27) | 4 (5) | 9 (16) | ||
| RICf | 117 (57) | 2 (3) | 70 (95) | 45 (80) | ||
| FluTBI | 52 (25) | 1 (1) | 42 (57) | 9 (16) | ||
| Treo-RIC | 65 (32) | 1 (1) | 28 (38) | 36 (64) | ||
| Received ATG | 119 (58) | 35 (47) | 27 (36) | 23 (41) | 0.409 | 1 |
| GVHD prophylaxis | < 0.001 | |||||
| CSA + short course of MTX | 128 (63) | 50 (67) | 32 (43) | 46 (82) | ||
| CSA + short course of MTX + MP | 25 (12) | 24 (32) | 0 (0) | 1 (2) | ||
| CSA + MMF | 52 (25) | 1 (1) | 42 (57) | 9 (16) |
aDefined by the presence of del17p (any percentage), t(4;14), or t(14;16)
bThe presence of plasma cells or plasmacytomas outside the bone marrow
c4 patients received dexamethasone monotherapy; 3 bortezomib, doxorubicin, and dexamethasone; 2 cyclophosphamide-dexamethasone; 1 cyclophosphamide, doxorubicin, and dexamethasone
d11 patients received two auto-SCTs
eMAC regimens included CyTBI (cyclophosphamide 60 mg/kg for 2 days and total body irradiation 12 Gy) and Treo14 (treosulfan 14 g/m2 for 3 days and fludarabine 30 mg/m2 for 5 days)
fRIC regimens included FluTBI (fludarabine 30 mg/m2/3 days and total body irradiation 2 Gy) and Treo-RIC (treosulfan 10–12 g/m2 for 3 days and flurarabine 30 mg/m2 for 5 days)
Upfront-allo allo-SCT performed first line without a previous auto-SCT, auto-allo allo-SCT performed after auto-SCT in first line, relapse allo-SCT performed after relapse, ISS International Staging System, allo-SCT allogeneic hematopoietic stem cell transplantation, AD doxorubicin and dexamethasone, VAD vincristine, doxorubicin, and dexamethasone, VCD bortezomib, cyclophosphamide, and dexamethasone, BorDex bortezomib and dexamethasone, RVD bortezomib, lenalidomide, and dexamethasone, MP melphalan and prednisone, IMID immunomodulatory drug, PI proteasome inhibitor, sCR stringent complete response, CR complete response, VGPR very good partial response, PR partial response, MR minimal response, SD stable disease, PD progressive disease, auto-SCT autologous stem cell transplantation, HLA human leucocyte antigen, MUD matched unrelated donor, BM bone marrow, PB peripheral blood, MAC myeloablative conditioning, RIC reduced-intensity conditioning, ATG antithymocyte globulin, GVHD graft-versus-host disease, CSA cyclosporine, MTX methotrexate, MP methylprednisolone, MMF mycophenolate mofetil