Impact of previous high-dose therapy on outcome after allografting for multiple myeloma

We describe a single centre experience of 33 patients allografted far multi ple myeloma, of which 28 received matched sibling marrow, one haploidentica l family donor marrow and four matched but unrelated donor marrow. Median f ollow-up after transplant is 27 months, and 13 patients are currently alive . One out of four patients with an unrelated donor survives and 12 out of 2 8 (42.8%) with matched sibling donors, Four patients were unevaluable becau se of early death (<day 21), and one patient experienced graft failure. The probability of overall survival is 35.7% at 3 years. The probability of di sease-free survival is 39% at 3 years, and the probability of treatment-rel ated mortality is 54% at 1 year. Acute GVHD developed in 26 (78.8%) patient s and was responsible for six deaths. Twenty-four patients (72.7%) develope d renal dysfunction and 22 (66.7%) developed hepatic dysfunction, Seventeen patients (51.5%) died of transplant-related problems in the first 150 days , and one at 6 months, Among the 13 survivors, none has experienced disease progression at a median follow-up of 27 months ( range 3-65 months). We co nclude that since allogeneic bone marrow transplantation is the only potent ially curative option in myeloma, it should be offered to younger patients early in the course of their disease, when procedure-related morbidity and mortality are likely to be at their lowest.