Allogeneic stem cell transplant (allo SCT) for multiple myeloma (MM) is potentially curative in some, while toxic in many others. We retrospectively analyzed 85 patients diagnosed with MM who underwent allo SCT as frontline or salvage therapy between 2000 and 2022 at Mayo Clinic Rochester and examined patient outcomes and prognostic markers. Overall survival (OS), progression free survival (PFS), treatment related mortality (TRM), and relapse rates (RR) were estimated using the Kaplan Meier method and competing risk models. Median follow-up was 11.5 years. Median OS and PFS were 1.7 and 0.71 years, respectively. Five-year OS and PFS were 22.2% and 15.1%, respectively. One-year TRM was 23.5%. Twelve patients demonstrated durable overall survival, living 10+ years beyond their allo SCT. This subgroup was more likely to have no or one prior auto SCT (p = 0.03) and to have been transplanted between 2000 and 2010 (p = 0.03). Outcomes were poor in this cohort with long follow-up, with few patients surviving 5 years or more, and most relapsing or dying within 2 years. We would expect better outcomes and tolerability with an expanded array of novel therapeutics and would prefer them to allo SCT.
异基因干细胞移植（allo SCT）治疗多发性骨髓瘤（MM）对部分患者可能具有治愈潜力，但在许多其他患者中则存在较高毒性。我们回顾性分析了2000年至2022年间在梅奥诊所罗切斯特院区接受前线或挽救性allo SCT治疗的85例MM患者，并评估了患者预后及相关预测标志物。采用Kaplan-Meier法和竞争风险模型评估总生存期（OS）、无进展生存期（PFS）、治疗相关死亡率（TRM）及复发率（RR）。中位随访时间为11.5年。中位OS与PFS分别为1.7年和0.71年。5年OS率与PFS率分别为22.2%和15.1%。1年TRM为23.5%。12例患者展现出持久的总生存期，在allo SCT后存活超过10年。该亚组患者更倾向于既往未接受或仅接受过一次自体干细胞移植（p=0.03），且移植时间集中在2000年至2010年间（p=0.03）。本队列在长期随访中总体预后较差，仅少数患者存活5年及以上，多数患者在2年内出现复发或死亡。随着新型治疗方案的不断扩展，我们预期将获得更好的疗效和耐受性，因此倾向于优先选择这些疗法而非allo SCT。
Long-term outcomes of allogeneic stem cell transplant in multiple myeloma
肿瘤(癌症)患者之家