Impact of early relapse after auto-SCT for multiple myeloma

S. Kumar, S. T. Mahmood, M. Q. Lacy, A. Dispenzieri, S. R. Hayman, F. K. Buadi, D. Dingli, S. V. Rajkumar, M. R. Litzow, M. A. Gertz

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Auto-SCT is an effective therapy for patients with multiple myeloma (MM), but nearly a fifth of these patients relapse within a year of auto-SCT. We studied 494 patients, undergoing auto-SCT within 12 months of diagnosis of MM. Patients were divided into two groups: early relapse (relapse ≤12 months from auto-SCT) and late relapse (either relapsed > 12 months after auto-SCT or disease free at the last follow up). One hundred twenty patients (24%) were in the early relapse and 374 (76%) were in the late-relapse groups. The early relapse group had a significantly shorter median overall survival (OS) from diagnosis (26.6 vs 90.7 months; P <0.001) and from auto-SCT (20.1 vs 82.5 months; P < 0.001). Among the 345 patients who have relapsed after auto-SCT, median OS from relapse was 10.8 months in the early relapse group compared to 41.8 months for the rest (P < 0.001) and was longer with increasing duration of response to the SCT. In multivariate analyses, labeling index ≥1% at transplant, greater than one treatment regimen prior to auto-SCT, and failure to achieve a complete response were predictive of early relapse. Patients who relapse within 12 months of an auto-SCT have a poor outcome and should be offered trials evaluating novel treatment approaches.

Original languageEnglish (US)
Pages (from-to)413-420
Number of pages8
JournalBone Marrow Transplantation
Volume42
Issue number6
DOIs
StatePublished - 2008

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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