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Plasma Cell Disorders

Autologous stem cell transplantation versus novel drugs or conventional chemotherapy for patients with relapsed multiple myeloma after previous ASCT

Bone Marrow Transplantation volume 50, pages 808–812 (2015)Cite this article

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Abstract

High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is the most common first-line treatment for patients with multiple myeloma (MM) under 65 years of age. A second ASCT at first relapse is frequently used but is challenged by the use of novel drugs. We retrospectively studied the outcome of second-line treatment in MM patients from the Nordic countries with relapse after first-line HDT and ASCT. Patients that underwent a second ASCT (n=111) were compared with patients re-treated with conventional cytotoxic drugs only (n=91) or with regimens including novel drugs (proteasome inhibitors and/or immunomodulatory drugs) (n=362) without a second ASCT. For patients receiving a second ASCT median overall survival was 4.0 years compared with 3.3 years (P<0.001) for the group treated with novel drugs and 2.5 years (P<0.001) for those receiving conventional cytotoxic drugs only. A second ASCT also resulted in a significantly longer second time to progression and a significantly longer time to next treatment. We conclude that, irrespective of the addition of novel drugs, MM patients in first relapse after ASCT still appear to benefit from a second ASCT. A second ASCT should be considered for all physically fit patients.

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Author notes

  1. M Grövdal and H Nahi: The author contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Karolinska Institutet, Center for Hematology, Karolinska University Hospital Huddinge, Stockholm, Sweden

    M Grövdal, H Nahi, G Gahrton & J Liwing

  2. Saint Olavs Hospital, Norwegian University of Science and Technology, Trondheim, Norway

    A Waage & J Hammerstrøm

  3. KG Jebsen Center for Myeloma Research, IKM, Norwegian University of Science and Technology, Trondheim, Norway

    A Waage & J Hammerstrøm

  4. Department of Hematology, Odense University Hospital, Odense, Denmark

    N Abildgaard

  5. Department of Hematology, Esbjerg Hospital, Esbjerg, Denmark

    P T Pedersen

  6. Department of Hematology, Turku University Hospital, Turku University, Turku, Finland

    A Laaksonen, M Putkonen & K Remes

  7. Department of Hematology, Kainuu Central Hospital, Kajaani, Finland

    P Bazia

  8. Department of Hematology, Tampere University Hospital, Tampere, Finland

    V Terava

  9. Department of Hematology, Satakunta Central Hospital, Pori, Finland

    H Ollikainen

  10. Department of Hematology, Kuopio University Hospital, Kuopio, Finland

    R Silvennoinen

  11. Department of Hematology, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland

    P Anttila & K Porkka

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  1. M Grövdal
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Correspondence to M Grövdal.

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Grövdal, M., Nahi, H., Gahrton, G. et al. Autologous stem cell transplantation versus novel drugs or conventional chemotherapy for patients with relapsed multiple myeloma after previous ASCT. Bone Marrow Transplant 50, 808–812 (2015). https://doi.org/10.1038/bmt.2015.39

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  • DOI: https://doi.org/10.1038/bmt.2015.39

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