Simple variables predict survival after autologous transplantation: a single centre experience in 181 multiple myeloma patients.
Autologous stem cell transplantation (ASCT) has an important role in the treatment of multiple myeloma (MM) patients. The aim of our study was to analyse retrospectively the impact of selected simple parameters on the survival of patients with MM after ASCT, including age, type of M-protein, stage of MM, treatment response, and presence of renal impairment. A total of 181 MM patients were transplanted in our centre between 1995 and 2004. The median follow-up from transplant was 59 months. Following ASCT, 29% of patients were in complete remission (CR) and 62% in partial remission (PR); 35% of patients had very good partial response (VGPR). Median time to progression (TTP) and overall survival (OS) from start of therapy were 33.0 and 78.3 months, respectively. Significant prognostic parameters for poor survival after ASCT were: age at transplant > 60 years (P < 0.001), TTP < 20 months (P < 0.001), IgA type of monoclonal immunoglobulin (P = 0.045), renal impairment with serum creatinine > 177 micromol/l (> 2 mg/dl; P = 0.004), clinical stage III according to ISS (P = 0.002) and no achievement of CR and/or VGPR after ASCT (P < 0.001). The stage of the disease before ASCT did not significantly affect OS after ASCT.
Krejci
M
M
Department of Internal Medicine-Haematooncology, Masaryk University Hospital, Brno, Czech Republic. mkrejci@fnbrno.cz
Hajek
R
R
Buchler
T
T
Krivanova
A
A
Svobodnik
A
A
Pour
L
L
Adam
Z
Z
Mayer
J
J
Vorlicek
J
J
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007072:Immunoglobulin D / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000628:therapy*; D009194:Myeloma Proteins / Q000378:metabolism*; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation; D015996:Survival Rate; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D007070:Immunoglobulin A; D007072:Immunoglobulin D; D007074:Immunoglobulin G; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins; D003404:Creatinine