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Autografting

Second auto-SCT for treatment of relapsed multiple myeloma

Abstract

High-dose therapy and auto-SCT remain integral in the initial treatment of multiple myeloma (MM), and are increasingly being applied for management of relapsed disease. We examined the outcomes in 98 patients undergoing salvage auto-SCT (auto-SCT2) for relapsed MM after receiving an initial transplant (auto-SCT1) between 1994 and 2009. The median age at auto-SCT2 was 60 years (range: 35–74). The median time between auto-SCT1 and auto-SCT2 was 46 months (range: 10–130). Treatment-related mortality was seen in 4%. The median PFS from auto-SCT2 was 10.3 (95% confidence interval (CI): 7–14) months and the median OS from auto-SCT2 was 33 months (95% CI: 28–51). In a multivariable analysis, shorter time to progression (TTP) after auto-SCT1, not achieving a CR after auto-SCT2, higher number of treatment regimens before auto-SCT2 and a higher plasma cell labeling index at auto-SCT2 predicted for shorter PFS. However, only a shorter TTP after auto-SCT1 predicted for a shorter OS post auto-SCT2. Hence, auto-SCT2 is an effective and feasible therapeutic option for MM patients relapsing after other treatments, especially in patients who had a TTP of at least 12 months after their auto-SCT1.

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Acknowledgements

This work is supported in part by Mayo Clinic Hematological Malignancies Program, Paul Calabresi K12 Award (CA96028). Supported in part by grants CA 107476, CA 62242, CA100707 and CA 83724 from the National Cancer Institute, Rockville, MD, USA. Also supported in part by the Jabbs Foundation, Birmingham, UK and the Henry J Predolin Foundation, USA.

Author contributions: SKK designed the study, collected and analyzed the data and wrote the manuscript; WIG collected the data and contributed to writing the manuscript; AD, MQL, MAG, SRH, FKB, DD and WJH contributed to writing and reviewing the manuscript.

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Correspondence to S K Kumar.

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Gonsalves, W., Gertz, M., Lacy, M. et al. Second auto-SCT for treatment of relapsed multiple myeloma. Bone Marrow Transplant 48, 568–573 (2013). https://doi.org/10.1038/bmt.2012.183

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