title: Outcome in Multiple Myeloma Patients Eligible for Stem Cell Transplantation: A Single-Center Experience.
abstract: Autologous hematopoietic stem cell transplantation (ASCT) is the standard of care for selected patients with multiple myeloma (MM). Many data exist on ASCT in the era of novel agents. We retrospectively analyzed 189 patients (108 males and 81 females) with biopsy-proven MM, who had received ASCT after induction therapy with either conventional chemotherapy alone or in combination with novel agents at our department. The outcomes of both groups and the risk factors for shorter survival were investigated. The most commonly used induction chemotherapy prior to ASCT was VAD (vincristine, doxorubicin and dexamethasone, 42%), followed by PAD (bortezomib, doxorubicin and dexamethasone, 21%). One-hundred and twenty-nine patients (68%) received cyclophosphamide-recombinant human granulocyte colony-stimulating factor for stem cell mobilization. No differences were observed for progression-free survival in terms of the number of transplanted CD34+ cells (p = 0.261). A trend in improved overall survival (OS) was seen for the use of novel agents when compared to conventional chemotherapy (164.3 vs. 82.0 months; p = 0.046). The International Staging System stages had a significant (p = 0.036) impact on OS. The novel agents improved OS in our patients with MM undergoing ASCT when compared to conventional chemotherapy regimens. The number of transplanted CD34+ cells had no significant impact on hematopoietic reconstitution.
authors.affiliation: Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lamm
authors.forename: Philipp
authors.initials: P
authors.lastname: Wohlfarth
authors.forename: Marija
authors.initials: M
authors.lastname: Bojic
authors.forename: Christian
authors.initials: C
authors.lastname: Schörgenhofer
authors.forename: Johannes
authors.initials: J
authors.lastname: Drach
authors.forename: Heinz
authors.initials: H
authors.lastname: Gisslinger
authors.forename: Nina
authors.initials: N
authors.lastname: Worel
authors.forename: Ana
authors.initials: A
authors.lastname: Schiefer
authors.forename: Axel
authors.initials: A
authors.lastname: Schulenburg
authors.forename: Hermine
authors.initials: H
authors.lastname: Agis
authors.forename: Peter
authors.initials: P
authors.lastname: Kalhs
authors.forename: Hildegard T
authors.initials: HT
authors.lastname: Greinix
authors.forename: Peter
authors.initials: P
authors.lastname: Schellongowski
authors.forename: Werner
authors.initials: W
authors.lastname: Rabitsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery*; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide