Autologous stem cell transplantation versus novel drugs or conventional chemotherapy for patients with relapsed multiple myeloma after previous ASCT.
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| Abstract |
High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is the most common first-line treatment for patients with multiple myeloma (MM) under 65 years of age. A second ASCT at first relapse is frequently used but is challenged by the use of novel drugs. We retrospectively studied the outcome of second-line treatment in MM patients from the Nordic countries with relapse after first-line HDT and ASCT. Patients that underwent a second ASCT (n=111) were compared with patients re-treated with conventional cytotoxic drugs only (n=91) or with regimens including novel drugs (proteasome inhibitors and/or immunomodulatory drugs) (n=362) without a second ASCT. For patients receiving a second ASCT median overall survival was 4.0 years compared with 3.3 years (P<0.001) for the group treated with novel drugs and 2.5 years (P<0.001) for those receiving conventional cytotoxic drugs only. A second ASCT also resulted in a significantly longer second time to progression and a significantly longer time to next treatment. We conclude that, irrespective of the addition of novel drugs, MM patients in first relapse after ASCT still appear to benefit from a second ASCT. A second ASCT should be considered for all physically fit patients.
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| Authors | M Grövdal, H Nahi, G Gahrton, J Liwing, A Waage, N Abildgaard, P T Pedersen, J Hammerstrøm, A Laaksonen, P Bazia, V Terava, H Ollikainen, R Silvennoinen, M Putkonen, P Anttila, K Porkka, K Remes |
| Journal | Bone marrow transplantation (Bone Marrow Transplant) Vol. 50 Issue 6 Pg. 808-12 (Jun 2015) ISSN: 1476-5365 [Electronic] England |
| PMID | 25867654 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study) |
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