Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect

Bone Marrow Transplant. 2001 Nov;28(9):841-8. doi: 10.1038/sj.bmt.1703253.


We report a series of 37 consecutive patients with multiple myeloma (MM) who received an allograft between 1990 and 2000 at our institution. Median age was 47 years, and nearly 70% of patients were Durie-Salmon stage III. A median of five cycles of chemotherapy were given before transplant, with a median interval between diagnosis and transplant of 9.3 months. We report a nonrelapse mortality rate of 22% with a median follow-up period of 40 months, whereas complete remission (CR) rate at 12 months is estimated at 57%. Treatment failure rate and overall survival at 40 months are estimated at 52% and 32%, respectively. The number of chemotherapy cycles prior to allotransplantation achieved borderline statistical significance as a poor prognosis factor for overall survival (P = 0.05), while the presence of chronic graft-versus-host disease (cGVHD) was significantly correlated with CR achievement (P = 0.036). Our study confirms that early allografting in MM can yield toxicity rates significantly lower than those associated with historical cohorts, and supports the hypothesis that cumulative chemotoxicity has a negative influence on mortality and survival rates. More importantly, our study clearly demonstrates an association between cGVHD and CR and brings further evidence in favor of a graft-versus-myeloma effect.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation* / mortality
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Dexamethasone / administration & dosage
  • Doxorubicin / administration & dosage
  • Graft vs Host Disease / immunology*
  • Graft vs Host Disease / mortality
  • Graft vs Tumor Effect* / immunology
  • Humans
  • Life Tables
  • Melphalan / administration & dosage
  • Middle Aged
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / therapy*
  • Prednisone / administration & dosage
  • Remission Induction
  • Retrospective Studies
  • Survival Analysis
  • Survival Rate
  • Transplantation, Homologous / immunology
  • Treatment Outcome
  • Vincristine / administration & dosage


  • Vincristine
  • Dexamethasone
  • Doxorubicin
  • Cyclophosphamide
  • Melphalan
  • Prednisone

Supplementary concepts

  • CHOP protocol
  • VAD protocol