Validation of prognostic factors and survival of patients with multiple myeloma in a real-life autologous stem cell transplantation setting: a Swiss single centre experience

Publication

Validation of prognostic factors and survival of patients with multiple myeloma in a real-life autologous stem cell transplantation setting: a Swiss single centre experience

Journal Paper/Review - May 31, 2011

Samaras Panagiotis, Stenner-Liewen Frank, Knuth Alexander, Bauer Stefan, Taverna Christian, Stussi Georg, Schanz Urs, Honegger Hanspeter, Zweifel Martin, Mischo Axel, Petrausch Ulf, Siciliano Raffaele Daniele, Haile Sarah, Blickenstorfer Marcel, Renner Christoph

Citation

Samaras P, Stenner-Liewen F, Knuth A, Bauer S, Taverna C, Stussi G, Schanz U, Honegger H, Zweifel M, Mischo A, Petrausch U, Siciliano R, Haile S, Blickenstorfer M, Renner C. Validation of prognostic factors and survival of patients with multiple myeloma in a real-life autologous stem cell transplantation setting: a Swiss single centre experience. Swiss Med Wkly 2011; 141:w13203.

Type

Journal Paper/Review (English)

Journal

Swiss Med Wkly 2011; 141

Publication Date

May 31, 2011

Issn Electronic

1424-3997

Pages

w13203

Brief description/objective

PRINCIPLES
High-dose chemotherapy with subsequent autologous stem cell transplantation (ASCT) is an important treatment option in younger patients with multiple myeloma (MM). We analysed the outcome of patients treated at our institution outside the clinical trials framework and tried to identify risk factors prognostic for survival.

METHODS
Medical histories of the patients were screened for response, event-free survival (EFS) and overall survival (OS). Pre-transplant variables were analysed to identify possible prognostic risk factors.

RESULTS
Overall, 182 ASCT were performed in 120 patients with MM from 2002 to 2007. Treatment-related mortality (TRM) was 0.5%. Median EFS was 23.1 months (95% confidence interval [CI]: 19.4-28.4) and median OS was 49.8 months (95%CI: 43.7 - not reached) in the whole patient population. The median OS in patients who received one ASCT was 46.4 months (95%CI: 35.2 - not reached), and 63.7 months (95%CI: 48.9 - not reached) in patients who underwent double ASCT. Patients who already achieved a complete remission (CR) before ASCT had a longer EFS (p = 0.016) than patients without CR. Additionally, patients who achieved a CR after ASCT had a longer EFS (p = 0.0061) and OS (p = 0.0024) than patients without CR. ISS stage
CONCLUSIONS
ASCT is a safe and effective treatment mode in eligible patients with MM. TRM was below average at our institution. Achievement of CR after transplantation was the most valuable predictor for improved overall survival.