Table 1.
(A) Patient characteristics at first and second transplants. (B) Number of transplants in each 5-year period for relapsed and graft failure patients. (C) Rates of acute and chronic GVHD and of engraftment following the second transplant.
| A | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Relapse cohort (n = 159) | Graft failure cohort (n = 56) | |||||||||||
| 1st allo-HCT | 2nd allo-HCT | 1st allo-HCT | 2nd allo-HCT | |||||||||
| Missing | N | % | Missing | N | % | Missing | N | % | Missing | N | % | |
| Gender | ||||||||||||
| M | 60 | 37.7 | 24 | 42.9 | ||||||||
| F | 99 | 62.3 | 32 | 57.1 | ||||||||
| MM | ||||||||||||
| IgA | 8 | 33 | 21.9 | 13 | 23.2 | |||||||
| IgG | 77 | 51 | 25 | 44.6 | ||||||||
| LC | 36 | 3.8 | 18 | 32.1 | ||||||||
| Non-sec | 3 | 2 | ||||||||||
| Other | 2 | 1.3 | ||||||||||
| Graft | ||||||||||||
| BM | 2 | 47 | 29.9 | 2 | 15 | 9.6 | 1 | 12 | 21.8 | 1 | 6 | 10.9 |
| CB | 1 | 0.6 | 1 | 0.6 | 2 | 3.6 | ||||||
| PB | 109 | 69.4 | 141 | 89.8 | 41 | 74.5 | 49 | 89.1 | ||||
| Donor | ||||||||||||
| HLA Id Sib | 2 | 108 | 68.8 | 3 | 95 | 60.9 | 23 | 41.8 | 1 | 21 | 38.2 | |
| Other | 49 | 31.2 | 61 | 39.1 | 32 | 58.2 | 34 | 61.8 | ||||
| Change of donor | ||||||||||||
| Other | 57 | 58 | 56.9 | 16 | 17 | 42.5 | ||||||
| Same | 44 | 43.1 | 23 | 57.5 | ||||||||
| EBMT score | ||||||||||||
| <4 | 11 | 49 | 33.1 | 15 | 3 | 2.1 | 3 | 7 | 13.2 | 8 | 2 | 4.2 |
| 4 | 40 | 27 | 18 | 12.5 | 12 | 22.6 | 9 | 18.8 | ||||
| 5 | 39 | 26.4 | 72 | 50 | 20 | 37.7 | 22 | 45.8 | ||||
| >5 | 20 | 13.5 | 51 | 35.4 | 14 | 26.4 | 15 | 31.2 | ||||
| Conditioning | ||||||||||||
| Reduced intensity | 17 | 84 | 59.2 | 26 | 73 | 54.9 | 3 | 42 | 79.2 | 8 | 33 | 68.8 |
| Myeloablative | 58 | 40.8 | 60 | 45.1 | 11 | 20.8 | 15 | 31.2 | ||||
| Karnofsky | ||||||||||||
| <80 | 40 | 7 | 5.9 | 33 | 25 | 19.8 | 11 | 1 | 2.2 | 11 | 17 | 37.8 |
| 80–100 | 112 | 94.1 | 101 | 80.2 | 44 | 97.8 | 28 | 62.2 | ||||
| Stage | ||||||||||||
| Low | 10 | 116 | 77.9 | 60 | 41.4 | 2 | 46 | 85.2 | 8 | 29 | 60.4 | |
| Advanced | 33 | 22.1 | 85 | 58.6 | 8 | 14.8 | 19 | 39.6 | ||||
| Interval Tx1–Tx2 (months) | 159 | 40.5 (1.5–170.4) | 56 | 3.5 (0.7–66.6) | ||||||||
| Age at Tx1 (yrs.) Med (range) | 48 (20–63) | 49 (25–68) | ||||||||||
| Year of Tx1 Med (range) | 2004 (1985–2016) | 2008 (1996–2017) | ||||||||||
| Age at Tx2 (yrs.) Med (range) | 51 (29–69) | 56 | 50 (25–68) | |||||||||
| Year of Tx2 Med (range) | 2008 (1994–2017) | 56 | 2008 (1996–2017) | |||||||||
| B | ||||
|---|---|---|---|---|
| Relapsed | Graft failure | |||
| Period | N | % | N | % |
| 1994–1998 | 14 | 8.8 | 2 | 3.6 |
| 1999–2003 | 26 | 16.4 | 10 | 17.9 |
| 2004–2008 | 41 | 25.8 | 16 | 28.6 |
| 2009–2013 | 43 | 27.0 | 19 | 33.9 |
| 2014–2017 | 35 | 22.0 | 9 | 16.1 |
| Total | 159 | 100.0 | 56 | 100.0 |
| C | |||||
|---|---|---|---|---|---|
| Donor | Relapsed myeloma (n = 159) | p value | Graft failure (n = 56) | ||
| GVHD | |||||
| Acute grade II GVHD | 16% (10–22%) | 12% (3–22%) | |||
| Acute grade III–IV GVHD | 14% (8–19%) | 15% (5–25%) | |||
| Death without GVHD | 12% (7–18%) | 17% (6–27%) | |||
| Acute grade II–IV GVHD | Other | 25% (14–36%) | 0.2 | 29% (13–45%) | 0.865 |
| HLAid-Sib-HLAid-Sib | 34% (23–45%) | 25% (4–46%) | |||
| Death without acute GvHD | Other | 14% (6–23%) | 0.619 | 19% (5–33%) | 0.539 |
| HLAid-Sib-HLAid-Sib | 11% (4–18%) | 12% (0–29%) | |||
| Acute GVHD with first allo | Other | 22% (8–36%) | 0.03 | ||
| Acute GVHD with first allo | HLAid-Sib-HLAid-Sib | 50% (33–67%) | |||
| No acute GVHD with first allo | Other | 26% (8–44%) | 17% (0–34%) | 0.53 | |
| No acute GVHD with first allo | HLAid-Sib-HLAid-Sib | 19% (5–32%) | 25% (1–49%) | ||
| Cum. incidence chronic GVHD 5 yrs | 40% (30–50%) | 36% (21–51%) | |||
| Death without cGVHD 5 yrs | 45% (35–56%) | 41% (25–56%) | |||
| Chronic GVHD at 1 year | Other | 34% (20–49%) | 0.828 | 29% (11–47%) | 0.802 |
| HLAid-Sib-HLAid-Sib | 30% (18–42%) | 21% (0–43%) | |||
| Death without cGVHD 1 year | Other | 25% (11–38%) | 0.6 | 38% (18–57%) | 0.942 |
| HLAid-Sib-HLAid-Sib | 22% (11–33%) | 29% (5–52%) | |||
| Neutrophil engraftment Day +28 | 94% (CI 90–98%) | 80% (69–92%) | |||
| Death without engraftment Day +28 | 5% (CI 1–8%) | 2% (0–6%) | |||
Bold values indicate statistical significance P < 0.05.