title: Predictive value of post-transplant bone marrow plasma cell percent in multiple myeloma patients undergone autologous transplantation.
abstract: OBJECTIVE
  Autologous stem cell transplantation (ASCT) has become the treatment of choice for patients with multiple myeloma (MM). Studies have shown that maintenance treatment with interferon-alpha is associated with improved survival rates following ASCT. However, despite these recent advances in regimes, relapses are inevitable; thus, the prediction of relapse following ASCT requires assessment.
  
  
  METHODS
  We retrospectively analyzed 39 patients who received ASCT between 2003 and 2008. All patients received chemotherapy with vincristine, adriamycin, and dexamethasone (VAD), and ASCT was performed following high-dose melphalan conditioning therapy. We evaluated the influence of the post-transplant day +14 (D+14) bone marrow plasma cell percent (BMPCp) (≥ 2 vs. < 2%), international scoring system (ISS) stage (II vs. III), response after 3 cycles of VAD therapy (complete response [CR] vs. non-CR), deletion of chromosome 13q (del[13q]) (presence of the abnormality vs. absence), and BMPCp at diagnosis (≥ 50 vs. < 50%) on progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  During the median follow-up of 28.0 months, the median PFS and OS were 29.1 and 42.1 months, respectively. By univariate analysis, ISS stage III at diagnosis, BMPCp ≥ 50% at diagnosis, CR after 3 cycles of VAD therapy, del (13q) by fluorescence in situ hybridization, and BMPCp ≥ 2% at post-transplant D+14 were correlated with PFS and OS. A multivariate analysis revealed that a post-transplant D+14 BMPCp ≥ 2% (PFS, hazard ratio [HR] = 4.426, p = 0.008; OS, HR = 3.545, p = 0.038) and CR after 3 cycles of VAD therapy (PFS, HR = 0.072, p = 0.014; OS, HR = 0.055, p = 0.015) were independent prognostic parameters.
  
  
  CONCLUSIONS
  Post-transplant D+14 BMPCp is a useful parameter for predicting the outcome for patients with MM receiving ASCT.
authors: Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Korea.
authors: In Hye
authors: IH
authors: Hwang
authors: Joo Seop
authors: JS
authors: Chung
authors: Ho Jin
authors: HJ
authors: Shin
authors: Young Jin
authors: YJ
authors: Choi
authors: Moo Kon
authors: MK
authors: Song
authors: Young Mi
authors: YM
authors: Seol
authors: Goon Jae
authors: GJ
authors: Cho
authors: Bo Gwang
authors: BG
authors: Choi
authors: Mun Ki
authors: MK
authors: Choi
authors: Bo Kyung
authors: BK
authors: Choi
authors: Kang Hee
authors: KH
authors: Ahn
authors: Kyung Hwa
authors: KH
authors: Shin
authors: Hee Sun
authors: HS
authors: Lee
authors: Hyung Seok
authors: HS
authors: Nam
authors: Jong Min
authors: JM
authors: Hwang
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010950:Plasma Cells / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014182:Transplantation, Autologous