Comparable Outcomes in Nonsecretory and Secretory Multiple Myeloma after Autologous Stem Cell Transplantation

Shaji Kumar, Waleska S. Pérez, Mei Jie Zhang, Karen Ballen, Asad Bashey, L. Bik To, Christopher N. Bredeson, Mitchell S. Cairo, Gerald J. Elfenbein, César O. Freytes, Robert Peter Gale, John Gibson, Robert A. Kyle, Martha Q. Lacy, Hillard M. Lazarus, Philip L. McCarthy, Gustavo A. Milone, Jan S. Moreb, Santiago Pavlovsky, Donna E. ReeceDavid H. Vesole, Peter H. Wiernik, Parameswaran Hari

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Nonsecretory myeloma (NSM) accounts for <5% of cases of multiple myeloma (MM). The outcome of these patients following autologous stem cell transplantation (ASCT) has not been evaluated in clinical trials. We compared the outcomes after ASCT for patients with NSM reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between 1989 and 2003, to a matched group of 438 patients (4 controls for each patient) with secretory myeloma (SM). The patients were matched using propensity scores calculated using age, Durie-Salmon stage, sensitivity to pretransplant therapy, time from diagnosis to transplant, and year of transplant. Disease characteristics were similar in both groups at diagnosis and at transplant except higher risk of anemia, hypoalbuminemia, and marrow plasmacytosis (in SM) and plasmacytoma (more in NSM). Cumulative incidence of treatment-related mortality (TRM), relapse, progression-free survival (PFS), and overall survival (OS) were similar between the groups. In multivariate analysis, based on a Cox model stratified on matched pairs and adjusted for covariates not considered in the propensity score, we found no difference in outcome between the NSM and SM groups. In this large cohort of patients undergoing ASCT, we found no difference in outcomes of patients with NSM compared to those with SM.

Original languageEnglish (US)
Pages (from-to)1134-1140
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume14
Issue number10
DOIs
StatePublished - Oct 1 2008

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Keywords

  • Autologous hematopoietic stem cell transplantation
  • Nonsecretory myeloma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Kumar, S., Pérez, W. S., Zhang, M. J., Ballen, K., Bashey, A., To, L. B., Bredeson, C. N., Cairo, M. S., Elfenbein, G. J., Freytes, C. O., Gale, R. P., Gibson, J., Kyle, R. A., Lacy, M. Q., Lazarus, H. M., McCarthy, P. L., Milone, G. A., Moreb, J. S., Pavlovsky, S., ... Hari, P. (2008). Comparable Outcomes in Nonsecretory and Secretory Multiple Myeloma after Autologous Stem Cell Transplantation. Biology of Blood and Marrow Transplantation, 14(10), 1134-1140. https://doi.org/10.1016/j.bbmt.2008.07.011