Efficacy and outcome of allogeneic transplantation in IgD and non secretory myeloma. A report on behalf of the myeloma subcommittee of the Chronic Malignancies Working Party of the EBMT

INTRODUCTION: We have recently reported on the outcome of autologous transplantation in the rare myelomas (IgD, IgE, IgM and non-secretory [NS]) but there is no real information on the outcome of these conditions following allogeneic transplantation.

PATIENTS AND METHODS: We have used the European Group for Blood and Marrow Transplantation Myeloma database to compare the outcomes following allogeneic transplantation of 1354 common myelomas (IgG, IgA and light chain myeloma) with the outcome in 26 IgD myelomas and 52 NS myelomas.

RESULTS: There was little difference between common and the IgD and NS myeloma patients with respect to prognostic factors although the IgD group had a higher Beta 2 microglobulin ((®)2 m) at diagnosis, shorter time to transplantation and more T-cell depletion. IgD and NS patients had a significantly greater achievement of CR at conditioning but this did not translate into equivalent progression free survival and overall survival for the IgD patients although the NS outcome was very similar to common myeloma.

CONCLUSIONS: The PFS and OS of IgD, common and NS myelomas appear similar following allogenic transplantation, despite a tendency for higher early relapse rate in IgD myeloma. Allogeneic transplantation may therefore be an option to investigate in prospective observational studies.