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Bone Marrow Transplant. 2009 Mar;43(5):417-22. doi: 10.1038/bmt.2008.334. Epub 2008 Oct 13.

Second auto-SCT is safe and effective salvage therapy for relapsed multiple myeloma.

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  • 1Bone Marrow and Stem Cell Transplant Program, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.


Therapeutic options for patients with multiple myeloma whose disease has relapsed after a prior auto-SCT include novel biologic therapies, traditional chemotherapy or a second transplant, with no clear standard of care. Few published studies address the safety and efficacy of a second auto-SCT for relapsed disease. We reviewed the Abramson Cancer Center experience with salvage auto-SCT for relapsed multiple myeloma. Forty-one patients had received a salvage auto-SCT at our institution; the median time between transplants was 37 months (range 3-91). The overall response rate in assessable patients was 55%, and treatment-related mortality was 7%. With a median follow-up time of 15 months, the median PFS was 8.5 months and the median overall survival (OS) was 20.7 months. In a multivariate analysis of OS, independent prognostic factors were >or=5 prior lines of therapy and time to progression after initial auto-SCT of <or=12 months. We conclude that in well-selected patients, salvage auto-SCT is safe and effective for relapsed myeloma.

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