Long-term prognostic significance of response in multiple myeloma after stem cell transplantation

Blood. 2011 Jul 21;118(3):529-34. doi: 10.1182/blood-2011-01-332320. Epub 2011 Apr 11.

Abstract

For establishing the true effect of different response categories in patients with multiple myeloma (MM) treated with autologous stem cell transplantation, we evaluated, after a median follow-up of 153 months, 344 patients with MM who received a transplant between 1989 and 1998. Overall survival (OS) at 12 years was 35% in complete response (CR) patients, 22% in near complete response (nCR), 16% in very good partial response (VGPR), and 16% in partial response (PR) groups. Significant differences in OS and progression-free survival were found between CR and nCR groups (P = .01 and P = .002, respectively), between CR and VGPR groups (P = .0001 and P = .003), or between CR and PR groups (P = .003 and P = < 10(-5)); no differences were observed between the nCR and VGPR groups (P = .2 and P = .9) or between these groups and the PR group (P = .1 and P = .8). A landmark study found a plateau phase in OS after 11 years; 35% patients in the CR group and 11% in the nCR+VGPR+PR group are alive at 17 years; 2 cases had relapsed in the nCR+VGPR+PR group. In conclusion, MM achieving CR after autologous stem cell transplantation is a central prognostic factor. The relapse rate is low in patients with > 11 years of follow-up, possibly signifying a cure for patients in CR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / mortality*
  • Multiple Myeloma / therapy*
  • Multivariate Analysis
  • Prognosis
  • Registries / statistics & numerical data
  • Remission Induction
  • Retrospective Studies
  • Survival Analysis