title: Fifteen years of single center experience with stem cell transplantation for multiple myeloma: a retrospective analysis.
abstract: BACKGROUND
  Autologous stem cell transplantation (ASCT) became standard of care for patients with multiple myeloma (MM) under the age of 65 years. We routinely perform ASCT for newly diagnosed MM since 1996 in our department.
  
  
  METHODS
  We retrospectively analyzed all 285 transplants in 185 patients done for MM from January 1996 till December 2010. We analyzed overall survival (OS) and progression-free survival (PFS) regarding conditioning, stage, complete or very good partial remission (CR, VGPR) achievement, renal impairment, single vs. double transplant.
  
  
  RESULTS
  Estimated 10-years survival of the whole set of patients is 39% (median survival 95 months). Patients with renal impairment show same OS as those without (p = 0.22). Patients show similar overall survival and event free survival regardless of type of transplant. We observed better outcome in terms of overall survival in patients treated with new drugs (p = 0.0014). Reaching CR or VGPR was not translated into better OS (p = 0.30) and EFS (p = 0.10). Also stage of the disease and whether single or double transplant was used did not make any significant difference in the outcome.
  
  
  CONCLUSIONS
  Stem cell transplantation greatly improved outcome of patients with MM. Poor outcome of allogeneic transplantation in our group of patients is related to high transplant related mortality (20% vs. 0%) and unexpected high relapse rate. There is a trend towards better survival, when new drugs are incorporated at any time in the course of the disease. This fact supports hypothesis that use of these drugs with ASCT should translate into better long-term outcome.
authors.affiliation: 4th Department of Hematology, Charles University in Prague, Faculty of Medicine, University Hospital, Hradec Králové, Czech Republic.
authors.forename: Jakub
authors.initials: J
authors.lastname: Radocha
authors.forename: Vladimír
authors.initials: V
authors.lastname: Maisnar
authors.forename: Alzbeta
authors.initials: A
authors.lastname: Zavrelová
authors.forename: Melanie
authors.initials: M
authors.lastname: Cermanová
authors.forename: Miriam
authors.initials: M
authors.lastname: Lánská
authors.forename: Miloslav
authors.initials: M
authors.lastname: Kmonícek
authors.forename: Ladislav
authors.initials: L
authors.lastname: Jebavý
authors.forename: Milan
authors.initials: M
authors.lastname: Bláha
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Malý
authors.forename: Pavel
authors.initials: P
authors.lastname: Zák
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate; D016896:Treatment Outcome