title: Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma.
abstract: BACKGROUND
  Multiple Myeloma (MM) is the commonest indication for autologous stem cell transplantation (ASCT).
  
  
  METHODS
  We retrospectively analysed data from 85 patients with MM submitted to ASCT in our centre from 2000 to 2010: 132 ASCT were realized, 80 of them as tandem.
  
  
  RESULTS
  After induction, 17.6% were in complete remission (CR), 41.2% in very good partial remission (VGPR) and 41.2% in partial remission (PR). After transplant 44.7% were in CR, 15.3% in VGPR and 40% in PR. With 22 months (range - 3 to 117 months) of median follow-up, median overall survival (OS) was 43 months and progression-free survival (PFS) 22 months. At 5 years, OS was 45.3% (36.7-53.9%, 95%) and PFS 24.5% (18-31%, 95%). Patients with CR after ASCT had significantly longer PFS as compared to patients with PR (27 vs 7 months; p = 0.034) but not when compared to patients with VGPR (27 vs 19 months, p = 0.485). The tandem approach represented an advantage in OS and PFS when compared to only one ASCT (31 vs 19 months - p = 0.018, and 40 vs 31 - p = 0.04, respectively).
  
  
  CONCLUSIONS
  Our results highlight the impact of response to transplant in patients PFS and tandem modality showed to carry better PFS and OS then the single transplant.
authors.affiliation: Service of Clinical Hematology, Hospital São João, Porto, Portugal. rui.bergantim@gmail.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Bergantim
authors.forename: Fernanda
authors.initials: F
authors.lastname: Trigo
authors.forename: José E
authors.initials: JE
authors.lastname: Guimarães