Safety and prognosis of allogenetic stem cell transplantation in younger patients with multiple myeloma

To evaluate the safety and prognosis of allogenetic stem cells transplantation in younger patients with multiple myeloma.We retrospectively investigated 32 young patients (median age: 45 years) diagnosed with multiple myeloma and received allogenetic stem cells transplantation in Changzheng Hospital. The non-relapse mortality, disease-related mortality, incidences of acute and chronic graft-versus-host disease (GVHD), and survivals of the patients were analyzed.Transplantation was successful in 31 of all the patients. Response could be evaluated in 28 patients. The complete response (CR)rate before transplantation was 25.0% (8/32), which rose to 82.1% (23/28) after transplantation.And 53.1% (17/32) of the patients developed acute GVHD, with 43.8% (14/32) developing grade Ⅰ-Ⅱ; 40.6% (13/32) of the patients developed chronic GVHD, with no extensive one. The median follow-up time was 18.1 (0.4-145.8) months.Sixteen patients died, including 10 cases of non-relapse deaths and 6 cases of disease-related deaths. The non-relapse mortality within 100 days was 9.4% (3/32). The 1-, 2-and 3-year non-relapse mortality rates were 21.9% (7/32), 28.1% (9/32) and 31.3% (10/32), respectively. The common causes of non-relapse mortality were pulmonary infection (7/10), acute GVHD (1/10), acute renal failure (1/10), and acute myocardial infarction (1/10). The disease-related mortality was 18.8% (6/32). The 1-, 2-and 3-year progression-free survival rates were 61.6%, 42.2%, and 37.5%, respectively. The median duration of progression-free survival was 20.3 months. The 1-, 2-and 3-years overall survival were 68.4%, 52.4% and 42.8%, respectively. The median duration of overall survival was 28.3 months. Patients that survived for over 2 years were all alive at the end of the follow-up.Allogenetic stem cell transplantation may be a promising curative therapeutic choice for young multiple myeloma patients. Transplantation-related death is the primary factor of prognosis. Pulmonary infection with infectious shock is the most common cause of non-relapse mortality. Prevention of infection after transplantation is the key to improve survivals.