Current Uses and Outcomes of Hematopoietic Cell Transplantation (HCT) INTRODUCTION: The Summary Slides are an annual report on data submitted to the CIBMTR by centers worldwide and describes information related to practices and general survival outcomes after hematopoietic cell transplantation. The current edition includes transplants performed prior to 2017. Slides 3 to 19 exhibit data on frequency of transplants according to age, donor and transplant type, graft source and disease, and causes of death. All frequencies represent first autologous and allogeneic transplants registered with the CIBMTR during the period. Slides 3, 4, 5 and 13 represent estimated frequencies of total number of transplants in the US. Slides 20 to 43 include overall survival outcomes according to disease, disease status, donor type, year of transplant and conditioning regimen intensity. Comparisons across survival curves are univariate and do not adjust for all potentially important factors; consequently, results should be interpreted cautiously. Acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), and chronic myelogenous leukemia (CML) have disease stage classified as early disease (first complete remission [CR1] or first chronic phase [CP1]), intermediate (second or subsequent CR or CP or accelerated phase [AP]), or advanced (primary induction failure, active disease, or blastic phase) disease. Myelodysplastic syndrome (MDS) disease stage is divided into early (refractory anemia [RA] or refractory anemia with ringed sideroblasts [RARS]), advanced (refractory anemia with excess of blasts [RAEB], refractory cytopenia with unilineage dysplasia [RCUD], refractory cytopenia with multilineage dysplasia [RCMD], or MDS with isolated del(5q). Myeloproliferative neoplasms (MPN) include myelofibrosis, polycythemia vera, essential thrombocythemia, chronic myelomonocytic leukemia, chronic myeloproliferative disease-unclassifiable, chronic neutrophilic leukemia, chronic eosinophilic leukemia and MPN-not otherwise specified. Lymphomas are classified according to sensitivity to prior chemotherapy (chemosensitive or chemoresistant). The classification of conditioning regimen intensity is based on the agents, doses and schedules used. Several classification systems are available, and for this report we used a composite classification. Cases defined as reduced-intensity by the transplant center were classified as such. Cases without such information and with available data on chemotherapy agents, radiation and doses, were classified according to the CIBMTR operational definition of conditioning regimen intensity: Myeloablative conditioning regimen: regimens with total body irradiation doses of ≥500 cGY, single fractionated doses of ≥800 cGY, busulfan doses of >9mg/kg, or melphalan doses of >150 mg/m2 given as single agents or in combination with other drugs. Reduced-intensity conditioning regimen: regimens with lower doses of total body irradiation, fractionated radiation therapy, busulfan, and melphalan than those used to define a myeloablative conditioning regimen (above). D’Souza A, Fretham C. Current use and outcome of hematopoietic stem cell transplantation: CIBMTR summary slides, 2017. Available at: http://www.cibmtr.org
Location of Centers Participating in the CIBMTR 2017* Slide 2: This slide shows the location of transplant centers that report data to the CIBMTR.
Annual Number of HCT Recipients in the US by Transplant Type Slide 3: The estimated annual numbers of transplant recipients in the U.S. were compiled according to the number of first transplants registered with the CIBMTR. Estimates of how closely the numbers reported are representative of actual transplant activity vary according to the type of transplant and number of centers reporting data per year. Prior to 2007, all transplants, except unrelated donor allogeneic transplants facilitated by the NMDP, were reported voluntarily. It was estimated that the CIBMTR captured 90% of all unrelated donor transplants performed in the US, 60-90% of related donor allogeneic transplants and 65 to 75% of autologous transplants. These estimates were extrapolated from other databases that capture transplant center activity, accreditation or hospital discharges. After 2007, the Stem Cell Transplant Outcomes Database (SCTOD) was initiated which changed reporting requirements and data capture to an electronic format. The SCTOD requires that all allogeneic transplants performed in the US be registered with CIBMTR. The numbers of allogeneic transplants from the US in the CIBMTR are representative of the total US transplant activity. Data reporting of autologous transplants remains voluntary and the numbers in the CIBMTR database are estimated to be 80% in 2016. The estimated annual number of allogeneic transplants recipients surpasses 8,000 a year in the US in 2013 with 8539 transplants estimated in 2016, up from 8474 in 2015. The number of autologous transplants recipients in the US continues to increase at a much faster rate, most prominently since 2010, mainly from transplants performed for plasma cell and lymphoproliferative disorders extending to older patients.
Allogeneic HCT Recipients in the US, by Donor Type Slide 4: Upon further stratifying the number of allogeneic transplants recipients in the US by donor type, recipients of unrelated donor transplants represent the largest group. The number of unrelated donor (URD) transplants has surpassed the number of allogeneic transplants from related donors after 2006 and the gap between these two types of approaches peaked in 2012. After 2012, the numbers of URD and HLA-identical siblings transplants has shown a downward trend in absolute numbers. Transplants performed with alternative donors is increasing. From 2003 to 2011, there were a steady increase in the numbers of transplants using umbilical cord blood as a result of several published studies demonstrating its benefit in both children and adults. From 2012 onward, there was an increase in the numbers of transplants from ‘Other Relatives’, likely due to the use of haploidentical donors with post-transplant cyclophosphamide strategy. In 2014, the numbers of transplants using ‘Other Relatives’ surpassed the total numbers of umbilical cord transplant performed in the US, accounting for 11% of all allogeneic transplants performed in the US. In 2016, this is the only group of donor type that is increasing with all other donor types showing decline or stability in use.
Allogeneic HCT Recipients in the US, by Donor Type Slide 5: This slide shows the relative trends with the use of unrelated, HLA-identical sibling and haploidentical donors in the US with an increasing trend in haploidentical HCT utility in the most recent years.
Haploidentical HCT Recipients in the US, by Graft Type Slide 6: The graft source was peripheral blood in over 65% of haploidentical transplants in 2016.
HLA-Matched Sibling Donor Allogeneic HCT in Patients <18 Years Slide 7: The annual numbers for HLA-matched sibling transplants in the pediatric population demonstrates a greater use of bone marrow grafts. The use of mobilized peripheral blood hematopoietic cells in recipients aged <18 years was 15-16% from 2012 to 2014. In 2015, it increased to 19% and in 2016, to 21%, among HLA-matched sibling transplants for pediatric recipients showing an increased trend toward the use of peripheral blood cells.
Unrelated Donor Allogeneic HCT in Patients <18 Years Slide 8: This slide demonstrates the overall utilization of unrelated donors in pediatric allogeneic transplant. Bone marrow remains the most common graft source for unrelated donors accounting for 50% in 2016. The use of umbilical cord blood peaked in 2009 at 48% of unrelated donor transplants but has since shown a downward trend and is at 28% of pediatric unrelated donor transplant activity in 2016. Peripheral blood accounted for 21% of pediatric unrelated donor graft type in 2016.
HLA-Matched Sibling Donor Allogeneic HCT in Patients Age ≥18 years Slide 9: Among adult recipients of HLA-matched sibling transplant, mobilized peripheral blood stem cells are the most common graft type. The proportion of bone marrow grafts for sibling transplants has ranged from 11% to 15% since 2006.
Unrelated Donor Allogeneic HCT in Patients Age ≥18 years Slide 10: Among adult recipients of unrelated donor transplants, mobilized peripheral blood stem cells is also the predominant graft source, accounting for 78% of unrelated donor transplants in 2016. This practice continues to remain high despite randomized clinical trial results demonstrating increased late complications such as chronic graft-versus-host disease with peripheral blood stem cells. The number of umbilical cord transplants in adults peaked at 12% in 2010 but has since declined to <10% and accounted for 8% of unrelated donor grafts in 2016 among adult recipients.
Trends in Autologous HCT in the US by Recipient Age^ Slide 11: The number of autologous transplants for treatment of malignant diseases in older patients continue to increase. Over 50% percent of autologous transplant recipients for lymphomas and multiple myeloma were older than 60 in 2016. There is a trend to increase use of autologous transplant in lymphomas and multiple myeloma in patients ≥70 years, representing 12% of autologous transplant activity in 2016.
Trends in Allogeneic HCT in the US by Recipient Age^ Slide 12: The number of allogeneic transplants for treatment of malignant diseases in ≥60 years also continues to increase. In 2016, 30% percent of allogeneic transplant recipients were older than 60. There is an increasing trend of ≥70 year recipients which represented 4.6% of allogeneic transplants for AML, ALL, NHL, HD, and MM in 2016.
Indications for Hematopoietic Cell Transplant in the US, 2016 Slide 13: The most common indications for HCT in the US in 2016 were multiple myeloma and lymphomas (NHL and HD) accounting for 63% of all HCTs. Acute leukemias (AML, ALL) and MDS (combined with MPNs) are the most common indications for allogeneic transplants accounting for 72% of allogeneic HCTs. MDS/MPN transplants have increased after the availability of Centers for Medicare and Medicaid Services (CMS)-approved Coverage with Evidence Development studies allowing allogeneic HCT in Medicare-insured patients for MDS (since 2010) and will continue to increase with the approval for myelofibrosis in 2017.
Selected Disease Trends for Allogeneic HCT in the US Slide 14: This slide represents trends in the utility of allogeneic transplants for various indications and shows that allogeneic transplant activity is decreasing in lymphomas and CLL highlighting the availability of non-transplant therapeutic options.
Selected Disease Trends for Autologous HCT in the US Slide 15: In 2016, the number of transplants for lymphomas decreased after a steady increase since 2007, and may represent the increased availability of novel non-transplant therapeutic options for some lymphoma subsets. The annual number of autologous transplants for multiple myeloma is increasing steadily. In 2016, 8776 myeloma autologous transplants were performed, up from 5621 in 2010.
Causes of Death after Autologous HCT done in 2014-2015 Slide 16: After an autologous HCT, primary disease is the most commonly reported cause of death representing 69% of deaths.
Causes of Death after HLA-Matched Sibling HCT done in 2014-2015 Slide 17: Among HLA-matched sibling transplant recipients, within the first 100 days, primary disease accounts for 27% of deaths, while infection and organ failure represent 36% of deaths. At or after 100 days, 58% of deaths are attributed to primary disease.
Causes of Death after Unrelated Donor HCT done in 2014-2015 Slide 18: Among unrelated donor allogeneic HCT, within 100 days, mortality related to infection, organ failure, GVHD accounts for 45% of deaths; after 100 days, 47% of deaths are related to primary disease.
Common Conditioning Regimens in AML or MDS Allogeneic HCT in the US in 2000-2015 Slide 19: This slide shows a breakdown of commonly used conditioning regimens for myeloablative (MAC) and reduced intensity (RIC) conditioning.
Survival after HLA-Matched Sibling Donor HCT for AML, 2005-2015 Slides 20 & 21: The CIBMTR has data for 33,130 patients receiving an HLA-matched sibling (n=13,118) or unrelated donor (n=20,012) transplant for AML between 2005 and 2015. Their disease status at the time of transplant and the donor type are the major predictors of post-transplant survival. The 3-year probabilities of survival after HLA-matched sibling transplant in this cohort was 59% ± 1%, 52% ± 1%, and 27% ± 1% for patients with early, intermediate, and advanced disease, respectively. The probabilities of survival after an unrelated donor transplant were 52% ± 1%, 49%± 1%, and 25% ± 1% for patients with early, intermediate, and advanced disease, respectively.
Survival after Unrelated Donor HCT for AML, 2005-2015 Slides 20 & 21: The CIBMTR has data for 33,130 patients receiving an HLA-matched sibling (n=13,118) or unrelated donor (n=20,012) transplant for AML between 2005 and 2015. Their disease status at the time of transplant and the donor type are the major predictors of post-transplant survival. The 3-year probabilities of survival after HLA-matched sibling transplant in this cohort was 59% ± 1%, 52% ± 1%, and 27% ± 1% for patients with early, intermediate, and advanced disease, respectively. The probabilities of survival after an unrelated donor transplant were 52% ± 1%, 49%± 1%, and 25% ± 1% for patients with early, intermediate, and advanced disease, respectively.
Survival after HLA Matched Sibling Donor HCT for AML, Age <18 Years, 2005-2015 Slide 22: Among 1,312 pediatric patients with AML receiving HLA-matched sibling transplant between 2005 and 2015, the 3-year probabilities of survival following transplant for early, intermediate, and advanced disease were 69% ± 2%, 60% ± 4%, and 29% ± 4%, respectively.
Survival after HLA-Matched Sibling HCT for Myelodysplastic Syndrome (MDS), 2005-2015 Slides 23 & 24: Allogeneic transplant is a potentially curative treatment for myelodysplastic syndrome (MDS). Outcomes differ according to disease status at the time of transplant. The CIBMTR has data on 7,611 patients receiving an allotransplants for early (n=2,717) and advanced (n=4,894) MDS performed between 2005 and 2015. The 3-year probabilities of survival were 52% ± 2% and 49% ± 1% for recipients of sibling and unrelated donor transplants for early MDS, respectively. Among patients with advanced MDS, corresponding probabilities were 45% ± 1% and 41% ± 1%.
Survival after Unrelated Donor HCT for Myelodysplastic Syndrome (MDS), 2005-2015 Slides 23 & 24: Allogeneic transplant is a potentially curative treatment for myelodysplastic syndrome (MDS). Outcomes differ according to disease status at the time of transplant. The CIBMTR has data on 7,611 patients receiving an allotransplants for early (n=2,717) and advanced (n=4,894) MDS performed between 2005 and 2015. The 3-year probabilities of survival were 52% ± 2% and 49% ± 1% for recipients of sibling and unrelated donor transplants for early MDS, respectively. Among patients with advanced MDS, corresponding probabilities were 45% ± 1% and 41% ± 1%.
Survival after Unrelated Donor HCT for MPNs, 2005-2015 Slides 25 & 26: Allogeneic transplants are a treatment choice for patients with myeloproliferative neoplasms (MPNs) who have high risk features. The CIBMTR has data for 3,542 patients receiving an unrelated donor (n=2,003) or an HLA-matched sibling transplant (n=1,539) for myeloproliferative neoplasms between 2005 and 2015, including 1,561 patients with myelofibrosis. The 3-year probabilities of survival were 54% ± 2% and 46% ± 2% for unrelated donor transplants with myelofibrosis and other MPNs. Among HLA-match sibling donor recipients for MPNs, the corresponding probabilities were 61% ± 2% and 52% ± 2%, respectively.
Survival after HLA-Matched Sibling Donor HCT for MPNs, 2005-2015 Slides 25 & 26: Allogeneic transplants are a treatment choice for patients with myeloproliferative neoplasms (MPNs) who have high risk features. The CIBMTR has data for 3,542 patients receiving an unrelated donor (n=2,003) or an HLA-matched sibling transplant (n=1,539) for myeloproliferative neoplasms between 2005 and 2015, including 1,561 patients with myelofibrosis. The 3-year probabilities of survival were 54% ± 2% and 46% ± 2% for unrelated donor transplants with myelofibrosis and other MPNs. Among HLA-match sibling donor recipients for MPNs, the corresponding probabilities were 61% ± 2% and 52% ± 2%, respectively.
Survival after HLA-Matched Sibling Donor HCT for ALL, Age <18 Years, 2005-2015 Slides 27 & 28: Among pediatric patients with ALL, chemotherapy generally has a high success rate, therefore allogeneic transplantation is commonly reserved for patients with high-risk disease (i.e. high leukocyte count at diagnosis and the presence of poor-risk cytogenetic markers), those who fail to achieve remission or those who relapse after chemotherapy. Among the 1,569 patients younger than 18 years receiving an HLA-matched sibling transplant for ALL between 2005 and 2015, the 3-year probabilities of survival were 73% ± 2%, 58% ± 2%, and 40% ± 5% for patients with early, intermediate, and advanced disease, respectively. The corresponding probabilities of survival among the 2,845 recipients of an unrelated donor transplant were 68% ± 2%, 56% ± 1%, and 43% ± 4%.
Survival after Unrelated Donor HCT for ALL, Age <18 years, 2005-2015 Slides 27 & 28: Among pediatric patients with ALL, chemotherapy generally has a high success rate, therefore allogeneic transplantation is commonly reserved for patients with high-risk disease (i.e. high leukocyte count at diagnosis and the presence of poor-risk cytogenetic markers), those who fail to achieve remission or those who relapse after chemotherapy. Among the 1,569 patients younger than 18 years receiving an HLA-matched sibling transplant for ALL between 2005 and 2015, the 3-year probabilities of survival were 73% ± 2%, 58% ± 2%, and 40% ± 5% for patients with early, intermediate, and advanced disease, respectively. The corresponding probabilities of survival among the 2,845 recipients of an unrelated donor transplant were 68% ± 2%, 56% ± 1%, and 43% ± 4%.
Survival after HLA-Matched Sibling Donor HCT for ALL, Age ≥18 Years, 2005-2015 Slides 29 & 30: Older age at disease onset is a high-risk feature in ALL. Consequently, a larger proportion of ALL patients 18 years of age or older undergo allogeneic HCT for early disease. Among 4,335 patients ≥18 years of age receiving HLA-matched sibling HCT for ALL between 2005-2015, the 3-year survival probabilities were 59% ± 1%, 39% ± 2%, and 28% ± 2% for patients with early, intermediate, and advanced disease, respectively. The corresponding probabilities among the 5,557 recipients of unrelated donor HCT were 57% ± 1%, 38% ± 1%, and 25% ± 2% for early, intermediate, and advanced disease, respectively.
Survival after Unrelated Donor HCT for ALL, ≥18 Years, 2005-2015 Slides 29 & 30: Older age at disease onset is a high-risk feature in ALL. Consequently, a larger proportion of ALL patients 18 years of age or older undergo allogeneic HCT for early disease. Among 4,335 patients ≥18 years of age receiving HLA-matched sibling HCT for ALL between 2005-2015, the 3-year survival probabilities were 59% ± 1%, 39% ± 2%, and 28% ± 2% for patients with early, intermediate, and advanced disease, respectively. The corresponding probabilities among the 5,557 recipients of unrelated donor HCT were 57% ± 1%, 38% ± 1%, and 25% ± 2% for early, intermediate, and advanced disease, respectively.
Survival after HLA Matched Sibling HCT for CML, 2005-2015 Slide 31: Allogeneic transplants for CML are currently reserved for patients where tyrosine kinase inhibitors have failed or are poorly tolerated. The CIBMTR has data for 2,015 HLA-matched sibling donor transplants for CML from 2005 to 2015. Three-year probabilities of survival were 66% ± 1%, 51% ± 4% and 29% ± 4% for patients in chronic phase, in accelerated phase and blast phase; respectively.
Survival after Allogeneic HCT for Chronic Lymphocytic Leukemia (CLL), 2005-2015 Slide 32: Allogeneic transplants are the main transplant modality for treatment of chronic lymphocytic leukemia (CLL) patients when standard chemotherapy fails or have high-risk features (e.g. cytogenetic abnormalities, short remission intervals, purine analog resistant disease). Among the 2,880 patients who underwent transplantation for CLL between 2005 and 2015, the 3-year probabilities of survival were 59% ± 2% and 51% ± 1% after transplants with HLA-matched sibling and unrelated donors, respectively.
Survival after Allogeneic HCT for Severe Aplastic Anemia, <18 Years, 2005-2015 Slides 33 & 34: Allogeneic HCT is the treatment of choice for young patients with severe aplastic anemia who have an available HLA-matched sibling donor. Among the 2,471 patients receiving HLA-matched sibling donor HCT for severe aplastic anemia between 2005 and 2015, the 3-year probability of survival was 91% ±1% for those younger than 18 years and 78% ± 1% for patients 18 years of age or older. Among the 1,751 recipients of unrelated donor HCT during the same period, the probabilities of survival were 78% ± 2% and 68% ± 2% for severe aplastic anemia patients under 18 years and ≥18 years respectively.
Survival after Allogeneic HCT for Severe Aplastic Anemia, ≥18 Years, 2005-2015 Slides 33 & 34: Allogeneic HCT is the treatment of choice for young patients with severe aplastic anemia who have an available HLA-matched sibling donor. Among the 2,471 patients receiving HLA-matched sibling donor HCT for severe aplastic anemia between 2005 and 2015, the 3-year probability of survival was 91% ±1% for those younger than 18 years and 78% ± 1% for patients 18 years of age or older. Among the 1,751 recipients of unrelated donor HCT during the same period, the probabilities of survival were 78% ± 2% and 68% ± 2% for severe aplastic anemia patients under 18 years and ≥18 years respectively.
Survival after Autologous HCT for Hodgkin Lymphoma, 2005-2015 Slide 35: Transplantation for Hodgkin Lymphoma (HL) is indicated in patients when disease relapses after initial chemotherapy or radiation therapy. Survival after transplant in HL depends on disease response to salvage therapy. Among the 9,287 patients receiving autologous HCT for HL between 2005 and 2015, the 3-year probabilities of survival were 84% ± 1% and 70% ± 2% for patients with chemosensitive and chemoresistant disease, respectively.
Survival after Allogeneic HCT for Hodgkin Lymphoma, 2005-2015 Slide 36: Allogeneic HCT for HL is generally reserved in patients who experience disease relapse after receiving multiple lines of therapy including autologous transplant or who have refractory disease and an available HLA-matched donor. Among 2,010 patients receiving allogeneic HCT for HL between 2005 and 2015, the 3-year probabilities of survival were 57% ± 2% and 54% ± 2% after sibling and unrelated donor transplants, respectively.
Survival after Autologous HCT for Follicular Lymphoma, 2005-2015 Slide 37: Transplantation for follicular lymphoma (FL) is generally reserved for patients with recurrent or aggressive disease. Autologous HCT is often done in patients with chemosensitive disease. Among the 2,602 patients receiving an auto transplant for FL between 2005 and 2015, the 3-year probabilities of survival were 79% ± 1% and 66% ± 4% for patients with chemosensitive and chemoresistant disease, respectively.
Survival after Allogeneic HCT for Follicular Lymphoma, 2005-2015 Slide 38: Allogeneic transplants for FL are performed in patients who experience disease relapse after multiple lines of therapy or who have refractory disease and an available HLA-matched donor. Among 904 patients receiving HLA-matched sibling donor transplants for FL between 2005 and 2015, the 3-year probabilities of survival were 72% ± 2% and 57% ± 5% for patients with chemosensitive and chemoresistant disease, respectively. The corresponding probabilities among the 853 patients receiving unrelated donor transplants in the same period were 66% ± 2% and 47% ± 4% for chemosensitive and chemoresistant disease, respectively.
Survival after Autologous HCT for Diffuse Large B-cell Lymphoma (DLBCL), 2005-2015 Slides 39 & 40: Autologous HCT are an accepted treatment indication for diffuse large B-cell lymphoma (DLBCL) often used at first relapse; similar to FL, most are performed in patients with chemosensitive disease. Among the 12,710 patients who received an autologous transplant for DLBCL between 2005 and 2015, the 3-year probabilities of survival were 65% ± 1% and 46% ± 2% for patients with chemosensitive and chemoresistant disease, respectively. Allogeneic HCT for treatment of DLBCL is performed less frequently than for FL and is generally used only in patients with aggressive disease that has been resistant to previous therapies, including autologous transplants. Among the 1,070 patients who underwent an HLA-matched sibling HCT for DLBCL from 2005 to 2015, the 3-year probabilities of survival were 51% ± 2% and 27% ± 3% for patients with chemosensitive and chemoresistant disease, respectively.
Survival after HLA-Matched Sibling HCT for Diffuse Large B-cell Lymphoma (DLBCL), 2005-2015 Slides 39 & 40: Autologous HCT are an accepted treatment indication for diffuse large B-cell lymphoma (DLBCL) often used at first relapse; similar to FL, most are performed in patients with chemosensitive disease. Among the 12,710 patients who received an autologous transplant for DLBCL between 2005 and 2015, the 3-year probabilities of survival were 65% ± 1% and 46% ± 2% for patients with chemosensitive and chemoresistant disease, respectively. Allogeneic HCT for treatment of DLBCL is performed less frequently than for FL and is generally used only in patients with aggressive disease that has been resistant to previous therapies, including autologous transplants. Among the 1,070 patients who underwent an HLA-matched sibling HCT for DLBCL from 2005 to 2015, the 3-year probabilities of survival were 51% ± 2% and 27% ± 3% for patients with chemosensitive and chemoresistant disease, respectively.
Survival after Allogeneic or Autologous HCT for Mantle Cell Lymphoma, 2005-2015 Slide 41: The optimal timing and type of HCT for mantle cell lymphoma (MCL) is not well defined. As with other mature B-cell lymphoproliferative disorders, autologous HCT is the more common transplant approach. Among the 5,076 patients who received an autotransplant for MCL between 2005 and 2015, the 3-year probability of survival was 81% ± 1%. Among 1,585 patients who underwent an allogeneic transplantation for MCL during the same period, the 3-year probabilities of survival was 53% ± 1% .
Survival after Salvage HCT for Multiple Myeloma, 2005-2015 Slide 42: Multiple myeloma (MM) is the most common indication for autologous HCT with slides 13 and 15 providing additional numbers. Multiple myeloma patients may receive a salvage transplant when the disease relapses. Among the 4,731 patients who received a salvage HCT for MM between 2005 and 2015, the 3-year probability of survival was 55% ± 1% and 43% ± 2% following salvage autologous HCT and salvage allogeneic HCT respectively.
Trends in survival after Autologous HCT for Multiple Myeloma, 2001-2015 Slide 43: Outcomes after autologous HCT with the use of novel agents and treatment paradigms such as post-transplant maintenance in the treatment of multiple myeloma have led to significant impact in overall survival recently. The 3-year overall survival among autotransplant recipients for multiple myeloma were 68% ± 1%, 73% ± 1% and 77% ± 1% of the transplants that were performed in 2001 to 2004, 2005 to 2008 and 2009 to 2012, respectively.