Matched-pair analysis to compare the outcomes of a second salvage auto-SCT to systemic chemotherapy alone in patients with multiple myeloma who relapsed after front-line auto-SCT
- Authors
- Yhim, H-Y; Kim, K.; Kim, J. S.; Kang, H. J.; Kim, J-A; Min, C-K; Bae, S. H.; Park, E.; Yang, D-H; Suh, C.; Kim, M. K.; Mun, Y-C; Eom, H. S.; Shin, H. J.; Yoon, H-J; Kwon, J. H.; Lee, J. H.; Kim, Y. S.; Yoon, S-S; Kwak, J-Y
- Issue Date
- Mar-2013
- Publisher
- NATURE PUBLISHING GROUP
- Keywords
- auto-SCT; multiple myeloma; salvage therapy
- Citation
- BONE MARROW TRANSPLANTATION, v.48, no.3, pp.425 - 432
- Journal Title
- BONE MARROW TRANSPLANTATION
- Volume
- 48
- Number
- 3
- Start Page
- 425
- End Page
- 432
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14715
- DOI
- 10.1038/bmt.2012.164
- ISSN
- 0268-3369
- Abstract
- The aims of this study were to investigate the outcomes of second salvage auto-SCT and to identify the impacts of a second auto-SCT compared with systemic chemotherapy alone on disease outcome. Data from 48 patients who underwent second auto-SCT were matched to 144 patients (1:3) who received systemic chemotherapy alone from the Korean Myeloma Registry. Groups were matched for nine potential prognostic factors and compared for treatment outcomes. The median age of matching-pairs at relapse was 55.5 years. A total of 156 patients (81%) received vincristine, doxorubicin and dexamethasone induction therapy before the first auto-SCT. Thirty-five patients (73%) in the second auto-SCT group received novel agent-based therapies before the second auto-SCT, and similar proportion in both groups received novel therapies after relapse of front-line auto-SCT. With a median follow-up of 553 months, patients who underwent a second auto-SET had significantly better median OS (55.5 vs 25.4 months, P=0.035). In multivariate analysis for OS, <18 months time to progression after first auto-SCT, International Staging System III and salvage chemotherapy alone were independent predictors for worse OS. The outcomes of second auto-SCT appear to be superior to those of systemic chemotherapy alone. A randomized trial comparing both treatment strategies is required. Bone Marrow Transplantation (2013) 48, 425-432; doi:10.1038/bmt.2012.164; published online 3 September 2012
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