Improving Outcomes Following Allogeneic Hematopoietic Cell ...

8 downloads 0 Views 51KB Size Report
Transplantation, University of Minnesota, Minneapolis, MN;. 5 Univ of Minnesota Div Hem/Onc Transplant, Minneapolis,. MN; 6 Medicine, Division of Hematology ...
S216

Abstracts / Biol Blood Marrow Transplant 22 (2016) S19eS481

control through the use of BV. Allogeneic HCT is now a more effective treatment.

LYMPHOMA/MULTIPLE MYELOMA

299 Improving Outcomes Following Allogeneic Hematopoietic Cell Transplantation for Hodgkin Lymphoma in Brentuximab Vedotin Era Veronika Bachanova 1, Livia Hegerova 2, Qing Cao 3, Aleksandr Lazaryan 4, Brian Lee McClune 5, Daniel J. Weisdorf 6, Claudio G. Brunstein 4. 1 University of Minnesota Medical Center, Minneapolis, MN; 2 University of Minnesota, Minneapolis, MN; 3 Biostatistics and Bioinformatics, University of Minnesota, Minneapolis, MN; 4 Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN; 5 Univ of Minnesota Div Hem/Onc Transplant, Minneapolis, MN; 6 Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN Background: Allogeneic hematopoietic cell transplantation (HCT) remains a valuable alternative for patients with advanced Hodgkin lymphoma (HL) who relapse after autologous HCT, are poorly responsive to chemotherapy, or fail to collect an adequate autologous graft. Updated data on survival after allogeneic HCT are needed to guide treatment decisions in the current era. Methods: We studied 72 patients with HL who received reduced intensity conditioning (RIC) allogeneic HCT and compared outcomes in 3 periods: 2009-2013 (n¼20) vs 2005-2008 (n¼27) vs 2000-2004 (n¼25). Results: Median age was 31 years (range 6-59), 58% were males, and 10% had reduced performance status. All patients had high-risk HL including lack of response to induction chemotherapy (5% vs 17% vs 28%). Patients received a median of 4.5 lines of prior therapy; BV was used exclusively after 2009 (60% vs 3% vs 0%) at a median of 4.5 cycles. Patients treated most recently (2009-2013) compared to earlier periods received less radiotherapy (55% vs 85%), had significantly less co-morbidities (co-morbidity index 0: 8% vs 15% vs 60%, p¼0.02) and attained higher rates of complete response (54% vs 20% vs 27%, p¼0.04). Grafts were mostly from an HLAmatched sibling or umbilical cord blood donor (35% and 56%). Median follow-up of survivors was 4.4 years (range 1-12.2 yrs). Non-relapse mortality (NRM), relapse, progression-free survival (PFS), and overall survival (OS) are shown in Table 1. PFS and OS at 2 years were superior for patients treated during 2009-2013 vs. earlier periods, reflecting lower NRM and relapse rates. In multivariable analysis adjusted for disease sensitivity and donor source, OS and PFS at 2 years remarkably improved for patients treated in recent years vs. 2000-2004 (reference period) [OS: 2009-2013 (HR 0.22; 95% CI 0.06-0.76) vs. 2005-2008 HR (0.71; 95% CI 0.28-1.8); p¼0.06 and PFS: 2009-2013 (HR 0.45; 95% CI 0.21-0.97) vs. 2005-2008 (HR 0.97; 95% CI 0.47-1.99); p¼0.09]. Conclusion: Survival of patients with advanced HL treated with allogeneic HCT has improved due to advances in transplant procedures and supportive care. In addition, survival after 2010 may have been improved by better disease

300 Predictors of Inferior Clinical Outcome in Patients with Standard Risk Multiple Myeloma Talha Badar 1, Qaiser Bashir 2, Nina Shah 2, Gheath Alatrash 3, Chitra Hosing 2, Uday R. Popat 4, Yago Nieto 2, Jatin Shah 5, Robert Z. Orlowski 5, Richard E. Champlin 4, Muzaffar H. Qazilbash 2. 1 leukemia, University of Texas MD Anderson Cancer Center, houston, TX; 2 Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX; 3 Lymphoma/ Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX; 4 Stem Cell Transplantation and Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX; 5 The University of Texas MD Anderson Cancer Center, Houston, TX Introduction: Outcome of multiple myeloma (MM) patients (pts) with standard-risk (SR) disease has improved significantly in the era of novel therapies and autologous hemopoietic stem cell transplant (auto-HCT). Even without maintenance therapy, their progression-free survival is approximately 24-30 months. However, subsets of patients with SR MM do worse. We tried to evaluate the factors associated with shorter PFS in pts with SR MM. Methods: We reviewed our database of 1750 MM pts who underwent auto-HCT between 2002 and 2010. We identified 61 SR MM pts, who received upfront auto-HCT and had a PFS of