Outcome of a Salvage Third Autologous Stem Cell Transplantation in Multiple Myeloma
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Outcome of a Salvage Third Autologous Stem Cell Transplantation in Multiple Myeloma. / Garderet, Laurent; Iacobelli, Simona; Koster, Linda; Goldschmidt, Hartmut; Johansson, Jan-Erik; Bourhis, Jean Henri; Krejci, Marta; Leleu, Xavier; Potter, Michael; Blaise, Didier; Koenecke, Christian; Peschel, Christian; Radocha, Jakub; Metzner, Bernd; Lenain, Pascal; Schäfer-Eckart, Kerstin; Pohlreich, David; Grasso, Mariella; Caillot, Denis; Einsele, Herman; Ladetto, Marco; Schönland, Stefan; Kröger, Nicolaus.
In: BIOL BLOOD MARROW TR, Vol. 24, No. 7, 07.2018, p. 1372-1378.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Outcome of a Salvage Third Autologous Stem Cell Transplantation in Multiple Myeloma
AU - Garderet, Laurent
AU - Iacobelli, Simona
AU - Koster, Linda
AU - Goldschmidt, Hartmut
AU - Johansson, Jan-Erik
AU - Bourhis, Jean Henri
AU - Krejci, Marta
AU - Leleu, Xavier
AU - Potter, Michael
AU - Blaise, Didier
AU - Koenecke, Christian
AU - Peschel, Christian
AU - Radocha, Jakub
AU - Metzner, Bernd
AU - Lenain, Pascal
AU - Schäfer-Eckart, Kerstin
AU - Pohlreich, David
AU - Grasso, Mariella
AU - Caillot, Denis
AU - Einsele, Herman
AU - Ladetto, Marco
AU - Schönland, Stefan
AU - Kröger, Nicolaus
N1 - Copyright © 2018 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2018/7
Y1 - 2018/7
N2 - To evaluate the outcomes of salvage third autologous stem cell transplantation (ASCT) in patients with relapsed multiple myeloma. We analyzed 570 patients who had undergone a third ASCT between 1997 and 2010 (European Society for Blood and Marrow Transplantation data), of whom 482 patients underwent tandem ASCT and a third ASCT at first relapse (AARA group) and 88 patients underwent an upfront ASCT with second and third transplantations after subsequent relapses (ARARA group). With a median follow-up after salvage third ASCT of 61 months in the AARA group and 48 months in the ARARA group, the day +100 nonrelapse mortality in the 2 groups was 4% and 7%, the incidence of second primary malignancy was 6% and 7%, the median progression-free survival was 13 and 8 months, and median overall survival (OS) was 33 and 15 months. In the AARA group, according to the relapse-free interval (RFI) from the second ASCT, the median OS after the third ASCT was 17 months if the RFI was <18 months, 37 months if the RFI was between 18 and 36 months, and 64 months if the RFI was ≥36 months (P < .001). In the ARARA group, the median OS after the third ASCT was 7 months if the RFI was <6 months, 13 months if the RFI was between 6 and 18 months, and 27 months if the RFI was ≥18 months (P < .001). In a multivariate analysis of the AARA group, the favorable prognostic factor was an RFI after second ASCT of ≥18 months. Progressive disease and a Karnofsky Performance Status score of <70 at third ASCT were unfavorable factors. A salvage third ASCT is of value for patients with relapsed myeloma, particularly for those with a long duration of response and chemosensitive disease at the time of transplantation.
AB - To evaluate the outcomes of salvage third autologous stem cell transplantation (ASCT) in patients with relapsed multiple myeloma. We analyzed 570 patients who had undergone a third ASCT between 1997 and 2010 (European Society for Blood and Marrow Transplantation data), of whom 482 patients underwent tandem ASCT and a third ASCT at first relapse (AARA group) and 88 patients underwent an upfront ASCT with second and third transplantations after subsequent relapses (ARARA group). With a median follow-up after salvage third ASCT of 61 months in the AARA group and 48 months in the ARARA group, the day +100 nonrelapse mortality in the 2 groups was 4% and 7%, the incidence of second primary malignancy was 6% and 7%, the median progression-free survival was 13 and 8 months, and median overall survival (OS) was 33 and 15 months. In the AARA group, according to the relapse-free interval (RFI) from the second ASCT, the median OS after the third ASCT was 17 months if the RFI was <18 months, 37 months if the RFI was between 18 and 36 months, and 64 months if the RFI was ≥36 months (P < .001). In the ARARA group, the median OS after the third ASCT was 7 months if the RFI was <6 months, 13 months if the RFI was between 6 and 18 months, and 27 months if the RFI was ≥18 months (P < .001). In a multivariate analysis of the AARA group, the favorable prognostic factor was an RFI after second ASCT of ≥18 months. Progressive disease and a Karnofsky Performance Status score of <70 at third ASCT were unfavorable factors. A salvage third ASCT is of value for patients with relapsed myeloma, particularly for those with a long duration of response and chemosensitive disease at the time of transplantation.
KW - Journal Article
U2 - 10.1016/j.bbmt.2018.01.035
DO - 10.1016/j.bbmt.2018.01.035
M3 - SCORING: Journal article
C2 - 29408334
VL - 24
SP - 1372
EP - 1378
JO - BIOL BLOOD MARROW TR
JF - BIOL BLOOD MARROW TR
SN - 1083-8791
IS - 7
ER -