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Autografting

The outcome of high-dose chemotherapy and auto-SCT in patients with multiple myeloma: a UK/Ireland and European benchmarking comparative analysis

Bone Marrow Transplantation volume 46, pages 1210–1218 (2011)Cite this article

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Abstract

Auto-SCT is the standard first-line consolidative therapy in patients with multiple myeloma (MM). We performed a national benchmarking outcome analysis for patients with MM who underwent a single auto-SCT in 1999 and 2005. They were identified from the British Society of Blood and Marrow Transplantation (BSBMT) (n=211 and n=453) and EBMT (n=1311 and n=1978) registries. An improvement in Day+100 and D+365 non-relapsed mortality (NRM) was shown between years 1999 and 2005 (P=0.0495). The 4-year relapse rate (RR) was significantly higher in 2005 (P=0.0003) and was associated with a shorter time to next treatment (TTNT) (P=0.025). The 4-year PFS was significantly lower in 2005 (P=0.0012), with the year of auto-SCT (P=0.001) and status at auto-SCT (P=0.02) being independently significant. The 4-year OS was similar between the year cohorts (P=0.266). In the ‘benchmarking’ comparison, the European Group for Blood and Marrow Transplantation (EBMT) 1999 cohort demonstrated the best PFS, although no year-of-transplant effect could be demonstrated on the 4-year OS rates (P=0.760). An improvement in supportive care resulting in reduced NRM is evident between the decades. The main cause of treatment failure remains disease progression. The similarity in OS between the years may reflect the introduction of novel agents in salvage therapy. The reduced PFS in 2005 is as yet not fully explained, but may represent recent disease response criterion standardization.

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Acknowledgements

We thank Dr Carmen Ruiz de Elvira, Head of EBMT registry, EBMT Central Office, London, for providing access to the EBMT ProMISe database. We also thank the programme directors and data managers of centres involved in this analysis: Aberdeen Royal Infirmary (D Culligan/A Shaw); Addenbrooke's Hospital Cambridge (C Crawley/D Tournant); Bangor Hospital (D Edwards/M Hunter); Birmingham Heartlands Hospital (D Milligan/A Shomoye); Bournemouth Hospitals (S Killick/S Pope); Coventry (B Harrison), Devon and Exeter Hospital (C Rudin); Glasgow Royal Infirmary (G McQuaker/F Kyalo); Guy's Hospital London (M Kazmi/K Hussein); Hammersmith Hospital London (J Apperley/F O’Boyle); John Radcliffe Hospital Oxford (T Littlewood/R Pawson); King's College Hospital London (A Pagliuca/J Downing); Leeds Teaching Hospitals (G Cook/K Benn); Leicester Infirmary (A Hunter/R Lewin); Liverpool University Hospital (R Clark/L Laing); Manchester Royal Infirmary (J Yin/M Waller); North Staffordshire Hospital (R Chasty/P Watson); Nottingham City Hospital (N Russell/C Hart); Plymouth Hospital (H Hunter/T Batchelor); Queen Elizabeth Hospital Birmingham (C Craddock/J Ward); Royal Free Hospital London (S MacKinnon/J Sudak); Royal Marsden Hospital (GJ Morgan/Helena Woods); Royal Victoria Hospital, Newcastle (GH Jackson/L McNally); St George's Hospital London (E Gordon-Smith/P Datta-Nemdharry); Salisbury Hospital (J Cullis); Sheffield Teaching Hospitals (J Snowden/B Holt); Southampton University Hospitals (K Orchard/C Hurlock); Taunton Hospital (S Bolam/M Ewings); Tayside Teaching Hospitals (D Meiklejohn/N Keenan); University Hospitals Bristol (D Marks/P Breslin); Western General Hospital Edinburgh (P Johnson/A Robertson). Authorship: Authorship was determined in accordance with the BSBMT Authorship policy (http://www.bsbmt.org/pages/46-CTC_Clinical_Trials_Committee). GC, GHJ and KK designed the study and GC, GHJ, RP and KK analysed the data. GC and GHJ wrote the article and KK, RP, JL, DIM and AP collected data, revised the article and gave final approval.

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Authors and Affiliations

  1. St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK

    G Cook

  2. Department of Haematology, Royal Victoria Hospital, Newcastle, UK

    G H Jackson

  3. Department of Haematology, The Royal Marsden Hospital, London, UK

    G J Morgan

  4. Department of Haematology, Nottingham University Hospital, Nottingham, UK

    N Russell

  5. BSBMT Data Registry, Guy's Hospital, London, UK

    K Kirkland, J Lee & R Pearce

  6. Department of Haematology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK

    D I Marks

  7. Department of Haematology, King's College Hospital, London, UK

    A Pagliuca

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Correspondence to G Cook.

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Cook, G., Jackson, G., Morgan, G. et al. The outcome of high-dose chemotherapy and auto-SCT in patients with multiple myeloma: a UK/Ireland and European benchmarking comparative analysis. Bone Marrow Transplant 46, 1210–1218 (2011). https://doi.org/10.1038/bmt.2010.283

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