1. Outcome of a Salvage Third Autologous Stem Cell Transplantation in Multiple Myeloma.
- Author
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Garderet, Laurent, Blaise, Didier, Koenecke, Christian, Peschel, Christian, Radocha, Jakub, Metzner, Bernd, Lenain, Pascal, Schäfer-Eckart, Kerstin, Pohlreich, David, Grasso, Mariella, Caillot, Denis, Iacobelli, Simona, Einsele, Herman, Ladetto, Marco, Kröger, Nicolaus, Koster, Linda, Goldschmidt, Hartmut, Schönland, Stefan, Johansson, Jan-Erik, and Bourhis, Jean Henri
- Subjects
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STEM cell transplantation , *MULTIPLE myeloma treatment , *AUTOTRANSPLANTATION , *HEALTH outcome assessment , *DISEASE relapse , *MULTIVARIATE analysis - Abstract
To evaluate the outcomes of salvage third autologous stem cell transplantation (ASCT) in patients with relapsed multiple myeloma. We analyzed 570 patients who had undergone a third ASCT between 1997 and 2010 (European Society for Blood and Marrow Transplantation data), of whom 482 patients underwent tandem ASCT and a third ASCT at first relapse (AARA group) and 88 patients underwent an upfront ASCT with second and third transplantations after subsequent relapses (ARARA group). With a median follow-up after salvage third ASCT of 61 months in the AARA group and 48 months in the ARARA group, the day +100 nonrelapse mortality in the 2 groups was 4% and 7%, the incidence of second primary malignancy was 6% and 7%, the median progression-free survival was 13 and 8 months, and median overall survival (OS) was 33 and 15 months. In the AARA group, according to the relapse-free interval (RFI) from the second ASCT, the median OS after the third ASCT was 17 months if the RFI was <18 months, 37 months if the RFI was between 18 and 36 months, and 64 months if the RFI was ≥36 months ( P < .001). In the ARARA group, the median OS after the third ASCT was 7 months if the RFI was <6 months, 13 months if the RFI was between 6 and 18 months, and 27 months if the RFI was ≥18 months ( P < .001). In a multivariate analysis of the AARA group, the favorable prognostic factor was an RFI after second ASCT of ≥18 months. Progressive disease and a Karnofsky Performance Status score of <70 at third ASCT were unfavorable factors. A salvage third ASCT is of value for patients with relapsed myeloma, particularly for those with a long duration of response and chemosensitive disease at the time of transplantation. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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