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Autografting

Matched-pair analysis to compare the outcomes of a second salvage auto-SCT to systemic chemotherapy alone in patients with multiple myeloma who relapsed after front-line auto-SCT

Bone Marrow Transplantation volume 48, pages 425–432 (2013)Cite this article

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Abstract

The aims of this study were to investigate the outcomes of second salvage auto-SCT and to identify the impacts of a second auto-SCT compared with systemic chemotherapy alone on disease outcome. Data from 48 patients who underwent second auto-SCT were matched to 144 patients (1:3) who received systemic chemotherapy alone from the Korean Myeloma Registry. Groups were matched for nine potential prognostic factors and compared for treatment outcomes. The median age of matching-pairs at relapse was 55.5 years. A total of 156 patients (81%) received vincristine, doxorubicin and dexamethasone induction therapy before the first auto-SCT. Thirty-five patients (73%) in the second auto-SCT group received novel agent-based therapies before the second auto-SCT, and similar proportion in both groups received novel therapies after relapse of front-line auto-SCT. With a median follow-up of 55.3 months, patients who underwent a second auto-SCT had significantly better median OS (55.5 vs 25.4 months, P=0.035). In multivariate analysis for OS, <18 months time to progression after first auto-SCT, International Staging System III and salvage chemotherapy alone were independent predictors for worse OS. The outcomes of second auto-SCT appear to be superior to those of systemic chemotherapy alone. A randomized trial comparing both treatment strategies is required.

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Acknowledgements

This work was supported by Fund of Biomedical Research Institute, Chonbuk National University Hospital and also supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (no. 20 110 029 703). This study was presented in part at the 2011 American Society of Hematology Annual Meeting in San Diego, CA, USA.

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Authors and Affiliations

  1. Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea

    H-Y Yhim & J-Y Kwak

  2. Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea

    H-Y Yhim & J-Y Kwak

  3. Department of Medicine, Division of Hematology and Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    K Kim

  4. Department of Internal Medicine, Division of Hematology, Yonsei University College of Medicine, Seoul, South Korea

    J S Kim

  5. Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea

    H J Kang

  6. Department of Hematology, St Vincent Hospital, Catholic University of Korea College of Medicine, Suwon, Korea

    J-A Kim

  7. Department of Hematology, Kangnam St Mary’s Hospital, Catholic University of Korea College of Medicine, Seoul, Korea

    C-K Min

  8. Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea

    S H Bae

  9. Department of Internal Medicine Chung-Ang University College of Medicine, Seoul, Korea

    E Park

  10. Department of Hematology–Oncology, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea

    D-H Yang

  11. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    C Suh

  12. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea

    M K Kim

  13. Department of Internal Medicine, Ewha Woman’s University School of Medicine, Seoul, Korea

    Y-C Mun

  14. Center for Specific Organs Cancer, National Cancer Center of Korea, Goyang, Korea

    H S Eom

  15. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea

    H J Shin

  16. Department of Hematology–Oncology, School of Medicine, Kyung Hee University, Seoul, Korea

    H-J Yoon

  17. Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea

    J H Kwon

  18. Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea

    J H Lee

  19. Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea

    Y S Kim

  20. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    S-S Yoon

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  1. H-Y Yhim
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  2. K Kim
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the Korean Multiple Myeloma Working Party (KMMWP)

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Correspondence to S-S Yoon or J-Y Kwak.

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Yhim, HY., Kim, K., Kim, J. et al. Matched-pair analysis to compare the outcomes of a second salvage auto-SCT to systemic chemotherapy alone in patients with multiple myeloma who relapsed after front-line auto-SCT. Bone Marrow Transplant 48, 425–432 (2013). https://doi.org/10.1038/bmt.2012.164

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