Journal Article

Efficacy of Up-Front Treatment with a Double Stem Cell Transplantation in Multiple Myeloma

Ki-Seong Eom, Chang-Ki Min, Seok Lee, Yoo-Jin Kim, Sung-Yong Kim, Hee-Je Kim, Jong-Wook Lee, Woo-Sung Min and Chun-Choo Kim

in Japanese Journal of Clinical Oncology

Volume 36, issue 7, pages 432-438
Published in print July 2006 | ISSN: 0368-2811
Published online June 2006 | e-ISSN: 1465-3621 | DOI: http://dx.doi.org/10.1093/jjco/hyl041
Efficacy of Up-Front Treatment with a Double Stem Cell Transplantation in Multiple Myeloma

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Background: We report the outcome of 53 patients with multiple myeloma (MM), who received autologous stem cell transplantation (ASCT) from April 1996 to September 2004 at our institution and who survived for more than 3 months after the transplant.

Methods: Following the first ASCT, 36 patients underwent an up-front second SCT, which consisted of either an ASCT (n = 24) or a reduced-intensity conditioning allogeneic stem cell transplant (RIST) (n = 12). Seventeen patients were given maintenance treatment.

Results: Seventy-seven percent of the patients (n = 41) showed an objective response to the initial therapy prior to the first ASCT. Overall, 60.4% (32 out of 53) and 32.1% (17 out of 53) of the patients had a complete response (CR) and partial response (PR) after the first ASCT, respectively. At the time of analysis, 34 patients (64.2%) were still alive. With a median follow-up of 32 months (range 9–98), the estimated progression-free survival (PFS) and overall survival (OS) at 5 years were 17.0 and 34.9%, respectively. Multivariate analysis revealed that the second SCT, normal hemoglobin and <50% marrow plasma cells were associated with an improved PFS. A second SCT, CR to the first SCT, female gender and an absence of advanced bone lesions were associated with a better OS.

Conclusions: A second SCT is the most significant factor for an improved PFS and OS after the first ASCT (P < 0.001, respectively). Up-front double SCT is needed to improve the OS and PFS in patients with MM.

Keywords: multiple myeloma; tandem stem cell transplantation; reduced-intensity allogeneic transplantation; autologous stem cell transplantation

Journal Article.  5186 words.  Illustrated.

Subjects: Medical Oncology

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