Significance of Salvage Autologous Stem Cell Transplantation for Relapsed Multiple Myeloma: A Nationwide Retrospective Study in Japan

Tsuyoshi Muta, Toshihiro Miyamoto, Tomohiko Kamimura, Yoshinobu Kanda, Masaharu Nohgawa, Yasunori Ueda, Koji Iwato, Osamu Sasaki, Takehiko Mori, Naoyuki Uchida, Shinsuke Iida, Takahiro Fukuda, Yoshiko Atsuta, Kazutaka Sunami

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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.

Original languageEnglish
Pages (from-to)35-44
Number of pages10
JournalActa Haematologica
DOIs
Publication statusAccepted/In press - 2018 Jan 17

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Keywords

  • Autologous hematopoietic cell transplantation
  • Multiple myeloma
  • Salvage therapy

ASJC Scopus subject areas

  • Hematology

Cite this

Muta, T., Miyamoto, T., Kamimura, T., Kanda, Y., Nohgawa, M., Ueda, Y., Iwato, K., Sasaki, O., Mori, T., Uchida, N., Iida, S., Fukuda, T., Atsuta, Y., & Sunami, K. (Accepted/In press). Significance of Salvage Autologous Stem Cell Transplantation for Relapsed Multiple Myeloma: A Nationwide Retrospective Study in Japan. Acta Haematologica, 35-44. https://doi.org/10.1159/000484652