title: Risk factors for relapse after complete remission with high-dose therapy for multiple myeloma.
abstract: Complete remission (CR) is an important surrogate for long-term survival for patients with multiple myeloma. However, most patients achieving CR eventually relapse and die from their disease. To better define the predictors of relapse, we conducted a retrospective review of outcomes for patients who achieved CR after autografting at our institution. From January 1990 to December 2002, among >400 patients transplanted, 81 (54 males and 27 females) achieved CR. With a median follow up of 58 months for all surviving patients, the 5-year progression-free survival (PFS) was 33% [95% confidence interval (CI) = 23 - 44] and 5-year overall survival (OS) was 67% (95% CI = 54 - 77). Median PFS was 37 months and median OS has not yet been reached. On multivariate analysis, high tumor mass at diagnosis emerged as a predictor of poor outcome. We conclude that high tumor mass at diagnosis predicts a significantly shorter remission duration for myeloma patients undergoing autografting.
authors.affiliation: Department of Blood and Marrow Transplantation UT-MD Anderson Cancer Center, Houston, TX 77030, USA. mqazilba@mdanderson.org
authors.forename: Muzaffar H
authors.initials: MH
authors.lastname: Qazilbash
authors.forename: Rima M
authors.initials: RM
authors.lastname: Saliba
authors.forename: Ana
authors.initials: A
authors.lastname: Aleman
authors.forename: X
authors.initials: X
authors.lastname: Lei
authors.forename: Donna
authors.initials: D
authors.lastname: Weber
authors.forename: Antonio
authors.initials: A
authors.lastname: Carrasco
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Giralt
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology* / Q000532:radiotherapy*; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D016896:Treatment Outcome