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

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

doi:10.1038/bmt.2012.164

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

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

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

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.

Original language	English
Pages (from-to)	425-432
Number of pages	8
Journal	Bone Marrow Transplantation
Volume	48
Issue number	3
DOIs	https://doi.org/10.1038/bmt.2012.164
State	Published - Mar 2013

Bibliographical note

Funding Information:
This work was supported by Fund of Biomedical Research Institute, Chonbuk National University Hospital and also supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (no. 20 110 029 703). This study was presented in part at the 2011 American Society of Hematology Annual Meeting in San Diego, CA, USA.

Keywords

auto-SCT
multiple myeloma
salvage therapy

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10.1038/bmt.2012.164

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Yhim, H. Y., Kim, K., Kim, J. S., Kang, H. J., Kim, J. A., Min, C. K., Bae, S. H., Park, E., Yang, D. H., Suh, C., Kim, M. K., Mun, Y. C., Eom, H. S., Shin, H. J., Yoon, H. J., Kwon, J. H., Lee, J. H., Kim, Y. S., Yoon, S. S., & Kwak, J. Y. (2013). 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. Bone Marrow Transplantation, 48(3), 425-432. https://doi.org/10.1038/bmt.2012.164

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title = "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",

abstract = "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.",

keywords = "auto-SCT, multiple myeloma, salvage therapy",

author = "Yhim, {H. Y.} and K. Kim and Kim, {J. S.} and Kang, {H. J.} and Kim, {J. A.} and Min, {C. K.} and Bae, {S. H.} and E. Park and Yang, {D. H.} and C. Suh and Kim, {M. K.} and Mun, {Y. C.} and Eom, {H. S.} and Shin, {H. J.} and Yoon, {H. J.} and Kwon, {J. H.} and Lee, {J. H.} and Kim, {Y. S.} and Yoon, {S. S.} and Kwak, {J. Y.}",

note = "Funding Information: This work was supported by Fund of Biomedical Research Institute, Chonbuk National University Hospital and also supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (no. 20 110 029 703). This study was presented in part at the 2011 American Society of Hematology Annual Meeting in San Diego, CA, USA.",

year = "2013",

month = mar,

doi = "10.1038/bmt.2012.164",

language = "English",

volume = "48",

pages = "425--432",

journal = "Bone Marrow Transplantation",

issn = "0268-3369",

publisher = "Nature Publishing Group",

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Yhim, HY, Kim, K, Kim, JS, Kang, HJ, Kim, JA, Min, CK, Bae, SH, Park, E, Yang, DH, Suh, C, Kim, MK, Mun, YC, Eom, HS, Shin, HJ, Yoon, HJ, Kwon, JH, Lee, JH, Kim, YS, Yoon, SS & Kwak, JY 2013, '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', Bone Marrow Transplantation, vol. 48, no. 3, pp. 425-432. https://doi.org/10.1038/bmt.2012.164

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AU - Yhim, H. Y.

AU - Kim, K.

AU - Kim, J. S.

AU - Kang, H. J.

AU - Kim, J. A.

AU - Min, C. K.

AU - Bae, S. H.

AU - Park, E.

AU - Yang, D. H.

AU - Suh, C.

AU - Kim, M. K.

AU - Mun, Y. C.

AU - Eom, H. S.

AU - Shin, H. J.

AU - Yoon, H. J.

AU - Kwon, J. H.

AU - Lee, J. H.

AU - Kim, Y. S.

AU - Yoon, S. S.

AU - Kwak, J. Y.

N1 - Funding Information: This work was supported by Fund of Biomedical Research Institute, Chonbuk National University Hospital and also supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (no. 20 110 029 703). This study was presented in part at the 2011 American Society of Hematology Annual Meeting in San Diego, CA, USA.

PY - 2013/3

Y1 - 2013/3

N2 - 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.

AB - 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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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

Abstract

Bibliographical note

Keywords

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