Japanese Journal of Clinical Oncology Advance Access originally published online on June 16, 2006
Japanese Journal of Clinical Oncology 2006 36(7):432-438; doi:10.1093/jjco/hyl041
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© 2006 Foundation for Promotion of Cancer Research
Efficacy of Up-Front Treatment with a Double Stem Cell Transplantation in Multiple Myeloma
Catholic Hematopoietic Stem Cell Transplantation Center, St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
For reprints and all correspondence: Chang-Ki Min, Division of Hematology, Department of Internal Medicine, St Mary's Hospital, #62 Youido-Dong, Youngdungpo-Gu, Seoul 150-713, South Korea. E-mail: ckmin{at}catholic.ac.kr
Received December 30, 2005; accepted March 27, 2006
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.
Key Words: multiple myeloma • tandem stem cell transplantation • reduced-intensity allogeneic transplantation • autologous stem cell transplantation
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  H.-S. Eom, C.-K. Min, B.-S. Cho, S. Lee, J.-W. Lee, W.-S. Min, C.-C. Kim, M. Kim, and Y. Kim Retrospective Comparison of Bortezomib-containing Regimens with Vincristine-Doxorubicin-Dexamethasone (VAD) as Induction Treatment Prior to Autologous Stem Cell Transplantation for Multiple Myeloma Jpn. J. Clin. Oncol., July 1, 2009; 39(7): 449 - 455. [Abstract] [Full Text] [PDF]
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C.-K. Min, M.-J. Lee, K.-S. Eom, S. Lee, J.-W. Lee, W.-S. Min, C.-C. Kim, M. Kim, J. Lim, Y. Kim, et al. Bortezomib in Combination with Conventional Chemotherapeutic Agents for Multiple Myeloma Compared with Bortezomib Alone Jpn. J. Clin. Oncol., December 21, 2007; (2007) hym126v1. [Abstract] [Full Text] [PDF]
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