Matched-pair analysis to compare the outcomes of a second salvage auto-SCT to systemic chemotherapy alone in patients with multiple myeloma who relapsed after front-line auto-SCT

被引:0
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作者
H-Y Yhim
K Kim
J S Kim
H J Kang
J-A Kim
C-K Min
S H Bae
E Park
D-H Yang
C Suh
M K Kim
Y-C Mun
H S Eom
H J Shin
H-J Yoon
J H Kwon
J H Lee
Y S Kim
S-S Yoon
J-Y Kwak
机构
[1] Chonbuk National University Medical School,Department of Internal Medicine
[2] Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital,Department of Medicine, Division of Hematology and Oncology
[3] Samsung Medical Center,Department of Internal Medicine, Division of Hematology
[4] Sungkyunkwan University School of Medicine,Department of Internal Medicine
[5] Yonsei University College of Medicine,Department of Hematology
[6] Korea Cancer Center Hospital,Department of Hematology
[7] St Vincent Hospital,Department of Internal Medicine
[8] Catholic University of Korea College of Medicine,Department of Hematology–Oncology
[9] Kangnam St Mary’s Hospital,Department of Oncology
[10] Catholic University of Korea College of Medicine,Department of Internal Medicine
[11] Daegu Catholic University Medical Center,Department of Internal Medicine
[12] Department of Internal Medicine Chung-Ang University College of Medicine,Department of Internal Medicine
[13] Chonnam National University Hwasun Hospital,Department of Hematology–Oncology
[14] Asan Medical Center,Department of Internal Medicine
[15] University of Ulsan College of Medicine,Department of Internal Medicine
[16] Yeungnam University College of Medicine,Department of Internal Medicine
[17] Ewha Woman’s University School of Medicine,Department of Internal Medicine
[18] Center for Specific Organs Cancer,undefined
[19] National Cancer Center of Korea,undefined
[20] Pusan National University School of Medicine,undefined
[21] School of Medicine,undefined
[22] Kyung Hee University,undefined
[23] Kangdong Sacred Heart Hospital,undefined
[24] Hallym University Medical Center,undefined
[25] Gachon University Gil Hospital,undefined
[26] Kosin University Gospel Hospital,undefined
[27] Seoul National University College of Medicine,undefined
来源
关键词
auto-SCT; multiple myeloma; salvage therapy;
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摘要
The aims of this study were to investigate the outcomes of second salvage auto-SCT and to identify the impacts of a second auto-SCT compared with systemic chemotherapy alone on disease outcome. Data from 48 patients who underwent second auto-SCT were matched to 144 patients (1:3) who received systemic chemotherapy alone from the Korean Myeloma Registry. Groups were matched for nine potential prognostic factors and compared for treatment outcomes. The median age of matching-pairs at relapse was 55.5 years. A total of 156 patients (81%) received vincristine, doxorubicin and dexamethasone induction therapy before the first auto-SCT. Thirty-five patients (73%) in the second auto-SCT group received novel agent-based therapies before the second auto-SCT, and similar proportion in both groups received novel therapies after relapse of front-line auto-SCT. With a median follow-up of 55.3 months, patients who underwent a second auto-SCT had significantly better median OS (55.5 vs 25.4 months, P=0.035). In multivariate analysis for OS, <18 months time to progression after first auto-SCT, International Staging System III and salvage chemotherapy alone were independent predictors for worse OS. The outcomes of second auto-SCT appear to be superior to those of systemic chemotherapy alone. A randomized trial comparing both treatment strategies is required.
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页码:425 / 432
页数:7
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