title: Long-term prognostic significance of response in multiple myeloma after stem cell transplantation.
abstract: For establishing the true effect of different response categories in patients with multiple myeloma (MM) treated with autologous stem cell transplantation, we evaluated, after a median follow-up of 153 months, 344 patients with MM who received a transplant between 1989 and 1998. Overall survival (OS) at 12 years was 35% in complete response (CR) patients, 22% in near complete response (nCR), 16% in very good partial response (VGPR), and 16% in partial response (PR) groups. Significant differences in OS and progression-free survival were found between CR and nCR groups (P = .01 and P = .002, respectively), between CR and VGPR groups (P = .0001 and P = .003), or between CR and PR groups (P = .003 and P = < 10(-5)); no differences were observed between the nCR and VGPR groups (P = .2 and P = .9) or between these groups and the PR group (P = .1 and P = .8). A landmark study found a plateau phase in OS after 11 years; 35% patients in the CR group and 11% in the nCR+VGPR+PR group are alive at 17 years; 2 cases had relapsed in the nCR+VGPR+PR group. In conclusion, MM achieving CR after autologous stem cell transplantation is a central prognostic factor. The relapse rate is low in patients with > 11 years of follow-up, possibly signifying a cure for patients in CR.
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Martinez-Lopez
authors.forename: Joan
authors.initials: J
authors.lastname: Blade
authors.forename: María-Victoria
authors.initials: MV
authors.lastname: Mateos
authors.forename: Carlos
authors.initials: C
authors.lastname: Grande
authors.forename: Adrián
authors.initials: A
authors.lastname: Alegre
authors.forename: José
authors.initials: J
authors.lastname: García-Laraña
authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.forename: Javier
authors.initials: J
authors.lastname: de la Rubia
authors.forename: Eulogio
authors.initials: E
authors.lastname: Conde
authors.forename: Rafael
authors.initials: R
authors.lastname: Martinez
authors.forename: Felipe
authors.initials: F
authors.lastname: de Arriba
authors.forename: Maria C
authors.initials: MC
authors.lastname: Viguria
authors.forename: Joan
authors.initials: J
authors.lastname: Besalduch
authors.forename: Rafael
authors.initials: R
authors.lastname: Cabrera
authors.forename: José D
authors.initials: JD
authors.lastname: Gonzalez-San Miguel
authors.forename: José Luis
authors.initials: JL
authors.lastname: Guzman-Zamudio
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Gomez del Castillo
authors.forename: José Maria
authors.initials: JM
authors.lastname: Moraleda
authors.forename: Juan C
authors.initials: JC
authors.lastname: García-Ruiz
authors.forename: Jesús
authors.initials: J
authors.lastname: San Miguel
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Lahuerta
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000628:therapy*; D015999:Multivariate Analysis; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis