1. Significance of Salvage Autologous Stem Cell Transplantation for Relapsed Multiple Myeloma: A Nationwide Retrospective Study in Japan.
- Author
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Muta, Tsuyoshi, Miyamoto, Toshihiro, Kamimura, Tomohiko, Kanda, Yoshinobu, Nohgawa, Masaharu, Ueda, Yasunori, Iwato, Koji, Sasaki, Osamu, Mori, Takehiko, Uchida, Naoyuki, Iida, Shinsuke, Fukuda, Takahiro, Atsuta, Yoshiko, and Sunami, Kazutaka
- Subjects
STEM cell transplantation ,MULTIPLE myeloma ,CELL transplantation ,PLASMACYTOMA ,MEDICAL care - Abstract
Autologous stem cell transplantation (ASCT) has been employed for patients with relapsed multiple myeloma (MM) after up-front ASCT. The present retrospective study aimed to examine the survival benefit from salvage ASCT. Among 446 patients with relapsed MM after up-front single ASCT, 70 patients received salvage ASCT, the employment of which reduced the risk of mortality after relapse (
p = 0.041). Using the parameters before initial ASCT, the advantage of salvage ASCT compared to standard therapy was confirmed in the subgroup with an international staging system stage of I or II (p = 0.040), good performance status (PS;p = 0.043), or no/mild renal comorbidity (p = 0.029). The advantage of salvage ASCT was also confirmed in the subgroup excluding those with early relapse within 7 months after initial ASCT (p = 0.026). Among patients who received salvage ASCT, a favorable prognosis is apparent for those with a time to relapse after initial ASCT of longer than 24 months. The overall survival after salvage ASCT was favorable excluding patients with the following factors: early relapse, poor PS, moderate/severe renal comorbidity, and progressive disease (p < 0.001). In conclusion,our results reinforced the evidence for encouraging salvage ASCT for eligible patients. [ABSTRACT FROM AUTHOR] - Published
- 2018
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