title: Autologous Stem Cell Transplantation in Multiple Myeloma in the Era of Novel Drug Induction: A Retrospective Single-Center Analysis.
abstract: Within this retrospective single-center study, we analyzed the survival of 320 multiple myeloma (MM) patients receiving melphalan high-dose chemotherapy (HDCT) and either single (n = 286) or tandem (n = 34) autologous stem cell transplantation (ASCT) from 1996 to 2012. Additionally, the impact of novel induction regimens was assessed. Median follow-up was 67 months, median overall survival (OS) 62 months, median progression-free survival (PFS) 33 months (95% CI 27-39), and treatment-related death (TRD) 3%. Multivariate analysis revealed age ≥60 years (p = 0.03) and stage 3 according to the International Staging System (p = 0.006) as adverse risk factors regarding PFS. Median OS was significantly better in newly diagnosed MM patients receiving induction therapy with novel agents, e.g., bortezomib, thalidomide, or lenalidomide, compared with a traditional regimen (69 vs. 58 months; p = 0.01). More patients achieved at least a very good partial remission in the period from 2005 to 2012 than from 1996 to 2004 (65 vs. 30%; p < 0.001), with a longer median OS in the later period (71 vs. 52 months, p = 0.027). In conclusion, our analysis confirms HDCT-ASCT as an effective therapeutic strategy in an unselected large myeloma patient cohort with a low TRD rate and improved prognosis due to novel induction strategies.
authors.affiliation: Department of Oncology, Hematology, and Bone Marrow Transplantation with Section of Pneumology, Hubertus Wald University Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Gabriela B
authors.initials: GB
authors.lastname: Thoennissen
authors.forename: Dennis
authors.initials: D
authors.lastname: Görlich
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bacher
authors.forename: Thomas
authors.initials: T
authors.lastname: Aufenberg
authors.forename: Anne-Christin
authors.initials: AC
authors.lastname: Hüsken
authors.forename: Anna Antonia
authors.initials: AA
authors.lastname: Hansmeier
authors.forename: Georg
authors.initials: G
authors.lastname: Evers
authors.forename: Jan-Henrik
authors.initials: JH
authors.lastname: Mikesch
authors.forename: Fleur
authors.initials: F
authors.lastname: Fritz
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.forename: Carsten
authors.initials: C
authors.lastname: Müller-Tidow
authors.forename: Matthias
authors.initials: M
authors.lastname: Stelljes
authors.forename: Rolf M
authors.initials: RM
authors.lastname: Mesters
authors.forename: Utz
authors.initials: U
authors.lastname: Krug
authors.forename: Martin H
authors.initials: MH
authors.lastname: Kropff
authors.forename: Nils H
authors.initials: NH
authors.lastname: Thoennissen
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Berdel
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D024221:Antineoplastic Protocols; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan
keywords: Autologous stem cell transplantation; Induction therapy ; Melphalan high-dose chemotherapy; Multiple myeloma ; Novel compounds; Tandem autologous stem cell transplantation