TY - JOUR
T1 - Significance of Salvage Autologous Stem Cell Transplantation for Relapsed Multiple Myeloma
T2 - A Nationwide Retrospective Study in Japan
AU - Muta, Tsuyoshi
AU - Miyamoto, Toshihiro
AU - Kamimura, Tomohiko
AU - Kanda, Yoshinobu
AU - Nohgawa, Masaharu
AU - Ueda, Yasunori
AU - Iwato, Koji
AU - Sasaki, Osamu
AU - Mori, Takehiko
AU - Uchida, Naoyuki
AU - Iida, Shinsuke
AU - Fukuda, Takahiro
AU - Atsuta, Yoshiko
AU - Sunami, Kazutaka
N1 - Funding Information:
aDepartment of Hematology/Oncology, Japan Community Health Care Organization (JCHO), Kyushu Hospital, Kita-Kyushu, bDepartment of Hematology/Oncology, Kyushu University Hospital, and cDepartment of Hematology, Hara-Sanshin Hospital, Fukuoka, dDivision of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, eDepartment of Hematology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, fDepartment of Hematology/Oncology and Transfusion and Hemapheresis Center, Kurashiki Central Hospital, Kurashiki, gDepartment of Hematology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, hDivision of Hematology, Miyagi Cancer Center, Natori, iDivision of Hematology, Department of Medicine, Keio University School of Medicine, and jDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, and kHematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, lDivision of Hematology and Oncology, Nagoya City University Hospital, Nagoya, mJapanese Data Center for Hematopoietic Cell Transplantation, and nDepartment of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, and oDepartment of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
Publisher Copyright:
© 2018 S. Karger AG, Basel.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Autologous stem cell transplantation (ASCT) has been employed for patients with relapsed multiple myeloma (MM) after up-front ASCT. The present retrospective study aimed to examine the survival benefit from salvage ASCT. Among 446 patients with relapsed MM after up-front single ASCT, 70 patients received salvage ASCT, the employment of which reduced the risk of mortality after relapse (p = 0.041). Using the parameters before initial ASCT, the advantage of salvage ASCT compared to standard therapy was confirmed in the subgroup with an international staging system stage of I or II (p = 0.040), good performance status (PS; p = 0.043), or no/mild renal comorbidity (p = 0.029). The advantage of salvage ASCT was also confirmed in the subgroup excluding those with early relapse within 7 months after initial ASCT (p = 0.026). Among patients who received salvage ASCT, a favorable prognosis is apparent for those with a time to relapse after initial ASCT of longer than 24 months. The overall survival after salvage ASCT was favorable excluding patients with the following factors: early relapse, poor PS, moderate/severe renal comorbidity, and progressive disease (p < 0.001). In conclusion, our results reinforced the evidence for encouraging salvage ASCT for eligible patients.
AB - Autologous stem cell transplantation (ASCT) has been employed for patients with relapsed multiple myeloma (MM) after up-front ASCT. The present retrospective study aimed to examine the survival benefit from salvage ASCT. Among 446 patients with relapsed MM after up-front single ASCT, 70 patients received salvage ASCT, the employment of which reduced the risk of mortality after relapse (p = 0.041). Using the parameters before initial ASCT, the advantage of salvage ASCT compared to standard therapy was confirmed in the subgroup with an international staging system stage of I or II (p = 0.040), good performance status (PS; p = 0.043), or no/mild renal comorbidity (p = 0.029). The advantage of salvage ASCT was also confirmed in the subgroup excluding those with early relapse within 7 months after initial ASCT (p = 0.026). Among patients who received salvage ASCT, a favorable prognosis is apparent for those with a time to relapse after initial ASCT of longer than 24 months. The overall survival after salvage ASCT was favorable excluding patients with the following factors: early relapse, poor PS, moderate/severe renal comorbidity, and progressive disease (p < 0.001). In conclusion, our results reinforced the evidence for encouraging salvage ASCT for eligible patients.
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U2 - 10.1159/000484652
DO - 10.1159/000484652
M3 - Article
C2 - 29339642
AN - SCOPUS:85040741675
SN - 0001-5792
VL - 139
SP - 35
EP - 44
JO - Acta Haematologica
JF - Acta Haematologica
IS - 1
ER -