title: Outcome of Patients With Nonsecretory Multiple Myeloma After Autologous Hematopoietic Stem Cell Transplantation.
abstract: BACKGROUND
  Fewer than 5% of patients have nonsecretory multiple myeloma (NSM), which is characterized by the absence of monoclonal protein in immunofixation in serum and urine. There are limited data on the outcome of NSM after autologous hematopoietic stem cell transplantation (auto-HCT).
  
  
  METHODS
  Between 1988 and December 2010, we identified 31 patients with NSM, and compared their outcome with 124 patients with secretory myeloma (SM) who were matched for age, disease stage, year of auto-HCT, and disease status and received auto-HCT at our institution. The primary end points were time to progression (TTP), progression-free survival (PFS), and overall survival (OS).
  
  
  RESULTS
  Nonrelapse mortality at 4 years was 4% and 4% in the NSM and SM patients, respectively (P = .612). Median follow-up was 102 and 74 months for NSM and SM patients, respectively. Median PFS was 37 (95% confidence interval [CI], 12-62) and 22 (95% CI, 18-26) months for NSM and SM patients, respectively (P = .527). Median OS was 51 (95% CI, 7-95) and 73 (95% CI, 59-86) months for NSM and SM patients, respectively (P = .740). In multivariate analyses, age >55 years, and relapsed disease were associated with a shorter TTP. Similarly, age >55 years, and relapsed or refractory disease at the time of auto-HCT were associated with a shorter OS.
  
  
  CONCLUSIONS
  Auto-HCT is associated with durable remission in NSM. There was no significant difference in transplant-related mortality, TTP, and PFS in patients with NSM compared with patients with SM after high-dose therapy and auto-HCT.
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Ryan W
authors.initials: RW
authors.lastname: Jacobs
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Rima M
authors.initials: RM
authors.lastname: Saliba
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Koji
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Shatha
authors.initials: S
authors.lastname: Farhan
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Aristides
authors.initials: A
authors.lastname: Armas
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Nina D
authors.initials: ND
authors.lastname: Shah
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Bashir
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Sofia
authors.initials: S
authors.lastname: Qureshi
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Simrit
authors.initials: S
authors.lastname: Parmar
authors.affiliation: Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Jatin J
authors.initials: JJ
authors.lastname: Shah
authors.affiliation: Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Michael
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Weber
authors.affiliation: Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Sheeba K
authors.initials: SK
authors.lastname: Thomas
authors.affiliation: Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Robert Z
authors.initials: RZ
authors.lastname: Orlowski
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.affiliation: Department of Stem Cell Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX. Electronic address: mqazilba@mdanderson.org.
authors.forename: Muzaffar H
authors.initials: MH
authors.lastname: Qazilbash
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009194:Myeloma Proteins / Q000032:analysis; D009367:Neoplasm Staging; D012008:Recurrence; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins
keywords: Autologous stem cell transplant; Nonsecretory myeloma; Overall survival; Progression-free survival; Response