Comparable outcomes in nonsecretory and secretory multiple myeloma after autologous stem cell transplantation.
Nonsecretory myeloma (NSM) accounts for <5% of cases of multiple myeloma (MM). The outcome of these patients following autologous stem cell transplantation (ASCT) has not been evaluated in clinical trials. We compared the outcomes after ASCT for patients with NSM reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between 1989 and 2003, to a matched group of 438 patients (4 controls for each patient) with secretory myeloma (SM). The patients were matched using propensity scores calculated using age, Durie-Salmon stage, sensitivity to pretransplant therapy, time from diagnosis to transplant, and year of transplant. Disease characteristics were similar in both groups at diagnosis and at transplant except higher risk of anemia, hypoalbuminemia, and marrow plasmacytosis (in SM) and plasmacytoma (more in NSM). Cumulative incidence of treatment-related mortality (TRM), relapse, progression-free survival (PFS), and overall survival (OS) were similar between the groups. In multivariate analysis, based on a Cox model stratified on matched pairs and adjusted for covariates not considered in the propensity score, we found no difference in outcome between the NSM and SM groups. In this large cohort of patients undergoing ASCT, we found no difference in outcomes of patients with NSM compared to those with SM.
Kumar
Shaji
S
Mayo Clinic, Rochester, Minnesota.
Pérez
Waleska S
WS
Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
Zhang
Mei-Jie
MJ
Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
Ballen
Karen
K
Massachusetts General Hospital, Boston, Massachusetts.
Bashey
Asad
A
The Blood and Marrow Transplant Group of Georgia, Atlanta, Georgia.
To
L Bik
LB
Institute of Medical and Veterinary Science, Adelaide, Australia.
Bredeson
Christopher N
CN
Medical College of Wisconsin, Milwaukee, Wisconsin.
Cairo
Mitchell S
MS
New York Presbyterian Hospital, New York, New York.
Elfenbein
Gerald J
GJ
Boston University, Boston, Massachusetts.
Freytes
César O
CO
University of Texas Health Science Center, San Antonio, Texas.
Gale
Robert Peter
RP
Celgene Corporation, Summit, New Jersey.
Gibson
John
J
Royal Prince Alfred Hospital, Camperdown, Australia.
Kyle
Robert A
RA
Mayo Clinic, Rochester, Minnesota.
Lacy
Martha Q
MQ
Mayo Clinic, Rochester, Minnesota.
Lazarus
Hillard M
HM
University Hospitals Case Medical Center, Cleveland, Ohio.
McCarthy
Philip L
PL
Roswell Park Cancer Institute, Buffalo, New York.
Milone
Gustavo A
GA
Fundaleu, Buenos Aires, Argentina.
Moreb
Jan S
JS
University of Florida, Gainesville, Florida.
Pavlovsky
Santiago
S
Fundaleu, Buenos Aires, Argentina.
Reece
Donna E
DE
Princess Margaret Hospital, Toronto, ON, Canada.
Vesole
David H
DH
St. Vincent's Comprehensive Cancer Center, New York, New York.
Wiernik
Peter H
PH
Our Lady of Mercy Medical Center, New York Medical College, Bronx, New York.
Hari
Parameswaran
P
Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: phari@mcw.edu.
D000328:Adult; D000704:Analysis of Variance; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome