Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Myeloma

Prognostic factors for survival after autologous transplantation: a single centre experience in 133 multiple myeloma patients

Bone Marrow Transplantation volume 35, pages 159–164 (2005)Cite this article

Abstract

Summary:

Autologous stem cell transplantation (ASCT) has an established role in the treatment of symptomatic multiple myeloma (MM). Our aim was to analyse the impact of selected prognostic parameters on the survival of patients with MM after ASCT. The new International Staging System (ISS) was also evaluated. A total of 133 MM patients were transplanted in our centre between 1995 and 2002. Following ASCT, 35% of patients were in complete remission (CR) and 60% were in partial remission (PR). The median progression-free (PFS) and overall (OS) survival from transplantation were 29.5 and 68.8 months, respectively. Transplant-related mortality (TRM) was 3%. On multivariate analysis, factors associated with significantly shorter OS were lack of CR after transplant (P=0.002, hazard ratio (HR): 3.1), stage 3 according to ISS (P=0.001, HR: 3.0) and age at transplant over 60 years (P=0.035, HR: 2.0). The status of disease before ASCT did not significantly affect PFS and OS after transplantation. We conclude that ASCT is a safe and effective procedure in MM patients, associated with low TRM. The survival after ASCT was dependent on response after ASCT, stage according to ISS and age.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Greenlee RT, Murray T, Bolden S, Wingo PA . Cancer statistics, 2000. CA Cancer J Clin 2000; 50: 7–33.

    Article  CAS  PubMed  Google Scholar 

  2. Durie B, Salmon S . A clinical staging system for multiple myeloma. Cancer 1975; 36: 842–854.

    Article  CAS  PubMed  Google Scholar 

  3. Greipp P, Lust JA, O'Fallon WM et al. Plasma cell labelling index and beta2-microglobulin predict survival independent of thymidine kinase and C-reactive protein in multiple myeloma. Blood 1993; 87: 3382–3387.

    Google Scholar 

  4. Grignani G, Gobbi PG, Formisano R et al. A prognostic index for multiple myeloma. Brit J Cancer 1996; 73: 1101–1107.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. San Miguel JF, Garcia-Sanz R, Gonzales M et al. A new staging system for multiple myeloma based on the number of S-phase plasma cells. Blood 1995; 89: 448–455.

    Google Scholar 

  6. Greipp PR, San Miguel JF, Fonsenca R et al. Development of an International Prognostic Index for myeloma: report of the International Myeloma Working Group. Hematol J 2003; 4 (Suppl. 1): 42 (Abstr. P7.1).

    Google Scholar 

  7. Greipp PR, Miguel JF, Durie BG et al. New International Staging System (ISS) for multiple myeloma from the International Myeloma Working Group. Blood 2003; 102: 190a (Abstr. 664).

    Google Scholar 

  8. Attal M, Harrousseau JL, Stopa AM et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Francais du Myelome. N Engl J Med 1996; 335: 91–97.

    Article  CAS  PubMed  Google Scholar 

  9. Barlogie B, Jagannath S, Vesole DH et al. Superiority of tandem transplantation over standard therapy for previously untreated multiple myeloma. Blood 1997; 89: 789–793.

    CAS  PubMed  Google Scholar 

  10. Barlogie B, Jagannath S, Desikan KR et al. Total therapy with tandem transplants for newly diagnosed multiple myeloma. Blood 1999; 93: 55–65.

    CAS  PubMed  Google Scholar 

  11. Lenhoff S, Hjorth M, Holmberg E et al. Impact on survival of high-dose therapy with autologous stem cell support in patients younger than 60 years with newly diagnosed multiple myeloma: a population-based study. Nordic Myeloma Study group. Blood 2000; 95: 7–11.

    CAS  PubMed  Google Scholar 

  12. Child JA, Morgan GJ, Davies FE et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. N Engl J Med 2003; 348: 1875–1883.

    Article  CAS  PubMed  Google Scholar 

  13. Facon T . Prognostic factors in low tumours mass asymptomatic multiple myeloma. Am J Hematol 1995; 48: 71–75.

    Article  CAS  PubMed  Google Scholar 

  14. Hajek R, Scudla V, Krejci M et al. Interim analysis of randomized trial 4W of Czech Myeloma Group: maintenance therapy interferon alpha or sequential maintenance therapy interferon alpha and dexamethasone after high-dose chemotherapy and peripheral blood stem cell transplantation in newly diagnosed patients with multiple myeloma. Hematol J 2003; 4 (Suppl. 1): 190 (Abstr. 230).

    Google Scholar 

  15. Durie BGM, Kyle RA, Belch A et al. Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation. Hematol J 2003; 4: 379–398.

    Article  PubMed  Google Scholar 

  16. Blade J, Samson D, Reece D et al. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. Br J Haematol 1998; 102: 1115–1123.

    Article  CAS  PubMed  Google Scholar 

  17. Tricot G, Spencer T, Sawyer J et al. Predicting long-term (⩾5 years) event-free survival in multiple myeloma patients following planned tandem autotransplants. Br J Haematol 2002; 116: 211–217.

    Article  PubMed  Google Scholar 

  18. Goldschmidt H, Hegenbert U, Wallmeier M et al. High-dose therapy with peripheral blood progenitor cell transplantation in multiple myeloma. Ann Oncol 1997; 8: 243–246.

    Article  CAS  PubMed  Google Scholar 

  19. Vesole DH, Barlogie B, Jagannath S et al. High dose therapy for refractory multiple myeloma: Improved prognosis with better supportive care and double transplants. Blood 1994; 84: 950–956.

    CAS  PubMed  Google Scholar 

  20. Terpos E, Apperley JF, Samson D et al. Autologous stem cell transplantation in multiple myeloma: improved survival in non secretory multiple myeloma but lack of influence of age, status at transplant, previous treatment and conditioning regimen. A single-centre experience in 127 patients. Bone Marrow Transplant 2003; 31: 163–170.

    Article  CAS  PubMed  Google Scholar 

  21. Alegre A, Diaz-Mediavilla J, San-Miguel J et al. Autologous peripheral blood stem cell transplantation for multiple myeloma: a report of 259 cases from Spanish Registry. Bone Marrow Transplant 1998; 21: 133–140.

    Article  CAS  PubMed  Google Scholar 

  22. Tribalto M, Amadori S, Cudillo L et al. Autologous peripheral blood stem cell transplantation as first line treatment of multiple myeloma: an Italian Multicenter Study. Haematologica 2000; 85: 52–58.

    CAS  PubMed  Google Scholar 

  23. Bjorkstrand B, Ljungman P, Svensson H et al. Allogeneic bone marrow transplantation versus autologous stem cell transplantation in multiple myeloma: a retrospective case-matched study from the European Group for Blood and Marrow Transplantation. Blood 1996; 88: 4711–4718.

    CAS  PubMed  Google Scholar 

  24. Majolino I, Vignetti M, Meloni G et al. Autologous transplantation in multiple myeloma: a GITMO retrospective analysis on 290 patients. Haematologica 1999; 84: 844–852.

    CAS  PubMed  Google Scholar 

  25. Bjorkstrand B . European Group for Blood and Marrow Transplantation Registry studies in multiple myeloma. Semin Hematol 2001; 38: 219–225.

    Article  CAS  PubMed  Google Scholar 

  26. Siegel DS, Desikan KR, Mehta J et al. Age is not a prognostic variable with autotransplants for multiple myeloma. Blood 1999; 93: 51–54.

    CAS  PubMed  Google Scholar 

  27. Sirohi B, Powles R, Treleaven J et al. The role of autologous transplantation in patients with multiple myeloma aged 65 years and over. Bone Marrow Transplant 2000; 25: 533–539.

    Article  CAS  PubMed  Google Scholar 

  28. Vesole DH, Simic A, Lazarus HM . Controversy in multiple myeloma transplants: a tandem autotransplants and mini-allografts. Bone Marrow Transplant 2001; 28: 725–735.

    Article  CAS  PubMed  Google Scholar 

  29. Dimopoulos MA, Hester J, Huh Y et al. Intensive chemotherapy with blood progenitor transplantation for primary resistant multiple myeloma. Br J Haematol 1994; 87: 730–734.

    Article  CAS  PubMed  Google Scholar 

  30. Alexanian R, Dimopoulos MA, Hester J et al. Early myeloablative therapy for multiple myeloma. Blood 1994; 84: 4278–4282.

    CAS  PubMed  Google Scholar 

  31. Vesole DH, Jagannath S, Tricot G et al. Autologous bone marrow and peripheral blood stem cell transplantation in multiple myeloma. Cancer Invest 1996; 14: 378–391.

    Article  CAS  PubMed  Google Scholar 

  32. Vesole DH, Crowley JJ, Catchatourian R et al. High-dose melphalan with autotransplantation for refractory multiple myeloma: results of a Southwest Oncology Group phase II trial. J Clin Oncol 1999; 17: 2173–2179.

    Article  CAS  PubMed  Google Scholar 

  33. Rajkumar SV, Fonseca R, Dispenzieri A et al. Effect of complete response on outcome following autologous stem cell transplantation for myeloma. Bone Marrow Transplant 2000; 26: 979–983.

    Article  CAS  PubMed  Google Scholar 

  34. Barlogie B, Jagannath S, Naucke S et al. Long-term follow-up after high-dose therapy for high-risk multiple myeloma. Bone Marrow Transplant 1998; 21: 1101–1107.

    Article  CAS  PubMed  Google Scholar 

  35. Bjorkstrand B, Svensson H, Goldschmidt H et al. Autologous stem cell transplantation in multiple myeloma – the 1999 EBMT registry update. Bone Marrow Transplant 1999; 23 (Suppl. 1): 100 (Abstr. 435).

    Google Scholar 

  36. Vesole DH, Tricot G, Jagannath S et al. Autotransplants in mutiple myeloma: what have we learned? Blood 1996; 88: 838–847.

    CAS  PubMed  Google Scholar 

  37. Harousseau JL, Attal M . The role of stem cell transplantation in multiple myeloma. Blood Rev 2002; 16: 245–253.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine – Haematooncology, Masaryk University Hospital, Brno, Czech Republic

    M Krejci, T Buchler, R Hajek, A Krivanova, L Pour, Z Adam, J Mayer & J Vorlicek

  2. Center of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic

    A Svobodnik

Authors
  1. M Krejci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Buchler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R Hajek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Svobodnik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Krivanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L Pour
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Z Adam
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J Vorlicek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Krejci.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krejci, M., Buchler, T., Hajek, R. et al. Prognostic factors for survival after autologous transplantation: a single centre experience in 133 multiple myeloma patients. Bone Marrow Transplant 35, 159–164 (2005). https://doi.org/10.1038/sj.bmt.1704728

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704728

Keywords

This article is cited by

Search

Advanced search

Quick links