¹Bone Marrow and Stem Cell Transplant Program, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA

Correspondence: Dr EA Stadtmauer, University of Pennsylvania School of Medicine, Abramson Cancer Center, 16 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA. E-mail: edward.stadtmauer@uphs.upenn.edu

Received 22 July 2008; Revised 9 September 2008; Accepted 11 September 2008; Published online 13 October 2008.

Abstract

Therapeutic options for patients with multiple myeloma whose disease has relapsed after a prior auto-SCT include novel biologic therapies, traditional chemotherapy or a second transplant, with no clear standard of care. Few published studies address the safety and efficacy of a second auto-SCT for relapsed disease. We reviewed the Abramson Cancer Center experience with salvage auto-SCT for relapsed multiple myeloma. Forty-one patients had received a salvage auto-SCT at our institution; the median time between transplants was 37 months (range 3–91). The overall response rate in assessable patients was 55%, and treatment-related mortality was 7%. With a median follow-up time of 15 months, the median PFS was 8.5 months and the median overall survival (OS) was 20.7 months. In a multivariate analysis of OS, independent prognostic factors were 5 prior lines of therapy and time to progression after initial auto-SCT of 12 months. We conclude that in well-selected patients, salvage auto-SCT is safe and effective for relapsed myeloma.