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Autografting

Impact of early relapse after auto-SCT for multiple myeloma

Bone Marrow Transplantation volume 42, pages 413–420 (2008)Cite this article

Abstract

Auto-SCT is an effective therapy for patients with multiple myeloma (MM), but nearly a fifth of these patients relapse within a year of auto-SCT. We studied 494 patients, undergoing auto-SCT within 12 months of diagnosis of MM. Patients were divided into two groups: early relapse (relapse ⩽12 months from auto-SCT) and late relapse (either relapsed >12 months after auto-SCT or disease free at the last follow up). One hundred twenty patients (24%) were in the early relapse and 374 (76%) were in the late-relapse groups. The early relapse group had a significantly shorter median overall survival (OS) from diagnosis (26.6 vs 90.7 months; P<0.001) and from auto-SCT (20.1 vs 82.5 months; P<0.001). Among the 345 patients who have relapsed after auto-SCT, median OS from relapse was 10.8 months in the early relapse group compared to 41.8 months for the rest (P<0.001) and was longer with increasing duration of response to the SCT. In multivariate analyses, labeling index ⩾1% at transplant, greater than one treatment regimen prior to auto-SCT, and failure to achieve a complete response were predictive of early relapse. Patients who relapse within 12 months of an auto-SCT have a poor outcome and should be offered trials evaluating novel treatment approaches.

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Acknowledgements

SK was involved in design of concept, data collection, analysis and writing the paper, STM, AD, MQL, SRH, FKB, DD, SVR, MRL and MAG were involved in writing the manuscript. This study was supported in part by Hematologic Malignancies Program, Mayo Clinic CR20 program, ASCO Young Investigator Award and Amgen Oncology Institute Junior Faculty Award (SK). It was presented in part at American Society of Clinical Oncology annual meeting, May 2007.

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  1. Divisions of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA

    S Kumar, S T Mahmood, M Q Lacy, A Dispenzieri, S R Hayman, F K Buadi, D Dingli, S V Rajkumar, M R Litzow & M A Gertz

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Correspondence to S Kumar.

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Kumar, S., Mahmood, S., Lacy, M. et al. Impact of early relapse after auto-SCT for multiple myeloma. Bone Marrow Transplant 42, 413–420 (2008). https://doi.org/10.1038/bmt.2008.180

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