Second auto-SCT is safe and effective salvage therapy for relapsed multiple myeloma.
Therapeutic options for patients with multiple myeloma whose disease has relapsed after a prior auto-SCT include novel biologic therapies, traditional chemotherapy or a second transplant, with no clear standard of care. Few published studies address the safety and efficacy of a second auto-SCT for relapsed disease. We reviewed the Abramson Cancer Center experience with salvage auto-SCT for relapsed multiple myeloma. Forty-one patients had received a salvage auto-SCT at our institution; the median time between transplants was 37 months (range 3-91). The overall response rate in assessable patients was 55%, and treatment-related mortality was 7%. With a median follow-up time of 15 months, the median PFS was 8.5 months and the median overall survival (OS) was 20.7 months. In a multivariate analysis of OS, independent prognostic factors were >or=5 prior lines of therapy and time to progression after initial auto-SCT of <or=12 months. We conclude that in well-selected patients, salvage auto-SCT is safe and effective for relapsed myeloma.
Olin
R L
RL
Bone Marrow and Stem Cell Transplant Program, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Vogl
D T
DT
Porter
D L
DL
Luger
S M
SM
Schuster
S J
SJ
Tsai
D E
DE
Siegel
D L
DL
Cook
R J
RJ
Mangan
P A
PA
Cunningham
K
K
Stadtmauer
E A
EA
D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D014182:Transplantation, Autologous