Yazarlar : Jimenez-Zepeda VH, Mikhael J, Winter A, Franke N, Masih-Khan E, Trudel S, Chen C, Kukreti V, Reece D.

Yayın : Biol Blood Marrow Transplant.

Yayın Yılı : 2011

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22062804

Konu : Kemik İliği Nakli

Literatür İçeriği :  

Abstract

The role of a second Autologous stem cell transplant (ASCT) as salvage therapy is unclear, particularly with the availability of novel agents to treat progressive multiple myeloma (MM).

METHODS:

We retrospectively reviewed all MM patients who received a second ASCT as salvage therapy at our center from March 1992 to December 2009.

RESULTS:

Eighty-one MM patients received a second ASCT for relapsed MM. The median time to relapse after first transplant was 39 months (9.83-100). All patients received re-induction therapy before second ASCT. The high-dose regimen given prior second ASCT consisted of melphalan (MEL) alone in the majority. Complete response, very good partial response and partial response were seen in 7.7%, 39.7% and 50%, respectively at day 100 post-ASCT; the median time to relapse post-second ASCT was 19 months. Early deaths occurred in 2.6%. Median progression-free survival (PFS) based on the time to myeloma relapse after first ASCT was 9.83 months (relapse </=24 months), and 17.3 months (relapse >/= 24 months) (p<0.05). Median overall survival (OS) was 28.47 months (relapse </= 24 months), and 71.3 months (relapse >24 months) (p=0.006).

CONCLUSIONS:

Second ASCT is a feasible and safe option for salvage therapy in MM. The best outcome was observed in patients whose time to progression was >24 months after the first ASCT, as these patients had a subsequent PFS lasting over 1 year and an OS of almost 6 years.

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