Autologous transplantation in 495 multiple myeloma patients - Analysis from the Czech National Registry of Hematopoietic Stem Cell Transplantation
Abstract
Autologous stem cell transplantation (ASCT) has an important role in the treatment of symptomatic multiple myeloma (MM) patients. The aim of our study was to analyse retrospectively the results of ASCT in 495 MM patients from the Czech National Registry of Hematopoietic Stem Cell Transplantation.
The data from 6 transplant centres were evaluated in order to identify significant variables associated with progression free survival (PFS) and overall survival (OS). Patients were transplanted between 1994 and 2005, the median age was 56 years, clinical stages according Durie-Salmon were as follows: stage I - 8 %, stage II - 29 %, stage III - 63 %.
Transplantation was performed during the first year from diagnosis in 411 patients (83 %). The median follow-up from ASCT was 33.3 months.
Transplant-related mortality to day +100 was 1 %, the median time to neutrophil engraftment was 12 days. The treatment responses after ASCT according to EBMT criteria were recorded in 149 patients (30 %), the complete response (CR) was achieved in 94 patients.
Median PFS and OS from transplantation were 27.5 and 62.3 months, respectively. The significant prognostic parameters for both poor PFS and OS were as follows: IgA type of monoclonal immunoglobulin, renal impairment at diagnosis, clinical stage III according to Durie-Salmon and failure to achieve CR after ASCT.
The status of disease before transplantation and the age did not significantly affect PFS and OS after ASCT. ASCT in multiple myeloma is a safe and an effective treatment method with a low toxicity.
The most significant prognostic factors for longer survival after transplant ASCT are lack of the renal impairment and achievement of CR after transplantation ASCT (p < 0.001).