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Alemtuzumab-based reduced-intensity conditioning allogeneic transplantation for myeloma and plasma cell leukemia - a
Karthik Ramasamy1, Shameem Mahmood, Ziyi Lim
1Kings College Hospital NHS Foundation Trust, London, England. karthik.ramasamy@kcl.ac.uk
Background:
Reduced-intensity conditioning allogeneic transplantation for myeloma is associated with lower non-relapse mortality and higher relapse rates in comparison with myeloablative conditioning transplants.
Patients And Methods:
We have retrospectively audited 19 patients with myeloma or primary plasma cell leukemia who received allogeneic transplantation with a uniform alemtuzumab-based reduced-intensity conditioning protocol. These patients had not been treated with bortezomib or lenalidomide before transplantation.
Results:
The treatment-related mortality at 1 year was (4/19) 21% with low incidence of graft-versus-host disease (6%) and 2-year progression-free survival and overall survival rates of 35% and 42%, respectively.
Conclusion:
Progression-free survival in this cohort of patients is comparable to previously published data of reduced-intensity conditioning allogeneic transplantation in myeloma. However, there is no plateau observed on the survival curves with a significant transplant-related mortality of 21%. Therefore, alemtuzumab-based allogeneic transplantation cannot be recommended as standard practice outside of clinical trials for treatment of myeloma.
