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
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 iden...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2011-05-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1295 |
| _version_ | 1798003536119726080 |
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| author | P Samaras M Blickenstorfer SR Haile D Siciliano U Petrausch A Mischo M Zweifel H Honegger U Schanz G Stüssi S Bauer A Knuth F Stenner-Liewen |
| author_facet | P Samaras M Blickenstorfer SR Haile D Siciliano U Petrausch A Mischo M Zweifel H Honegger U Schanz G Stüssi S Bauer A Knuth F Stenner-Liewen |
| author_sort | P Samaras |
| collection | DOAJ |
| description |
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 <III at first diagnosis strongly correlated with improved EFS (p = 0.0006) and OS (p <0.0001).
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.
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| first_indexed | 2024-04-11T12:10:26Z |
| format | Article |
| id | doaj.art-23130b6c7a9c4ffdb219ace4eab4bd3a |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T12:10:26Z |
| publishDate | 2011-05-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-23130b6c7a9c4ffdb219ace4eab4bd3a2022-12-22T04:24:38ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972011-05-01141212210.4414/smw.2011.13203Validation of prognostic factors and survival of patients with multiple myeloma in a real-life autologous stem cell transplantation setting: a Swiss single centre experienceP SamarasM BlickenstorferSR HaileD SicilianoU PetrauschA MischoM ZweifelH HoneggerU SchanzG StüssiS BauerA KnuthF Stenner-Liewen 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 <III at first diagnosis strongly correlated with improved EFS (p = 0.0006) and OS (p <0.0001). 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. https://www.smw.ch/index.php/smw/article/view/1295autologous stem cell transplantationmultiple myelomaoutcome.risk factors |
| spellingShingle | P Samaras M Blickenstorfer SR Haile D Siciliano U Petrausch A Mischo M Zweifel H Honegger U Schanz G Stüssi S Bauer A Knuth F Stenner-Liewen 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 Medical Weekly autologous stem cell transplantation multiple myeloma outcome. risk factors |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | autologous stem cell transplantation multiple myeloma outcome. risk factors |
| url | https://www.smw.ch/index.php/smw/article/view/1295 |
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