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In the relapse group, overall survival (OS) was 38% (30\u201346%) at 2 years and 25% (17\u201332%) at 5 years. Patients who had a HLA-identical sibling (HLAid-Sib) donor for their first and second transplants had superior OS (5 year OS: HLAid-Sib\/HLAid-Sib: 35% (24\u201346%); Others 9% (0\u201317%), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was a significantly higher incidence of acute grade II-IV GvHD in those patients who had also developed GvHD following their initial HLA-identical sibling allo-HCT (HLAid-Sib\/HLAid-Sib: 50% (33\u201367%); Other 22% (8\u201336%), <jats:italic>p<\/jats:italic>\u2009=\u20090.03). More as opposed to fewer than 2 years between transplants was associated with superior 5-yr OS (31% (21\u201340%) vs. 10% (1\u201320%), <jats:italic>P<\/jats:italic>\u2009=\u20090.005). On multivariate analysis, consecutive HLA-identical sibling donor transplants conferred a significant OS advantage (0.4 (0.24\u20130.67), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the graft failure group, OS was 41% at 2 years. In summary, a second allo-HCT using a HLA-identical sibling donor, if available, provides the best transplant outcomes for relapsed myeloma in this setting.<\/jats:p>","DOI":"10.1038\/s41409-021-01286-x","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T14:06:14Z","timestamp":1620741974000},"page":"2367-2381","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Second allogeneic transplants for multiple myeloma: a report from the EBMT Chronic Malignancies Working Party"],"prefix":"10.1038","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-4503","authenticated-orcid":false,"given":"Patrick J.","family":"Hayden","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk-Jan","family":"Eikema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liesbeth 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