title: Comparable outcomes in nonsecretory and secretory multiple myeloma after autologous stem cell transplantation.
abstract: 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.
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Waleska S
authors.initials: WS
authors.lastname: Pérez
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Karen
authors.initials: K
authors.lastname: Ballen
authors.affiliation: The Blood and Marrow Transplant Group of Georgia, Atlanta, Georgia.
authors.forename: Asad
authors.initials: A
authors.lastname: Bashey
authors.affiliation: Institute of Medical and Veterinary Science, Adelaide, Australia.
authors.forename: L Bik
authors.initials: LB
authors.lastname: To
authors.affiliation: Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Bredeson
authors.affiliation: New York Presbyterian Hospital, New York, New York.
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Cairo
authors.affiliation: Boston University, Boston, Massachusetts.
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Elfenbein
authors.affiliation: University of Texas Health Science Center, San Antonio, Texas.
authors.forename: César O
authors.initials: CO
authors.lastname: Freytes
authors.affiliation: Celgene Corporation, Summit, New Jersey.
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Gibson
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.affiliation: University Hospitals Case Medical Center, Cleveland, Ohio.
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: Philip L
authors.initials: PL
authors.lastname: McCarthy
authors.affiliation: Fundaleu, Buenos Aires, Argentina.
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Milone
authors.affiliation: University of Florida, Gainesville, Florida.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Moreb
authors.affiliation: Fundaleu, Buenos Aires, Argentina.
authors.forename: Santiago
authors.initials: S
authors.lastname: Pavlovsky
authors.affiliation: Princess Margaret Hospital, Toronto, ON, Canada.
authors.forename: Donna E
authors.initials: DE
authors.lastname: Reece
authors.affiliation: St. Vincent's Comprehensive Cancer Center, New York, New York.
authors.forename: David H
authors.initials: DH
authors.lastname: Vesole
authors.affiliation: Our Lady of Mercy Medical Center, New York Medical College, Bronx, New York.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wiernik
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: phari@mcw.edu.
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Hari
mesh_terms: 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