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ABSTRACT Patients with myeloma relapsing after tandem transplant have a poor survival and treatment options are limited. The role of additional salvage transplant procedures for these

patients is unknown. To evaluate the benefit and identify prognostic factors, the outcome of 76 consecutive patients with recurrent myeloma after tandem transplant receiving salvage

transplants (ST) was analyzed. Prior to ST, 23 patients (30%) had shown chemosensitive response to preceding salvage chemotherapy: two complete remissions (CR); eight near CRs (nCR: only

immunofixation positive); 13 partial remissions (PR ⩾75% reduction in M protein). Fifty received an autologous transplant, 22 a sibling-matched allogeneic transplant, and four a

matched-unrelated allogeneic transplant. Overall response after ST was 59%: eight CRs (11%); 14 nCRs (18%); 23 PRs (30%). Overall survival (OS) at 2 years was 19%; 2 year event-free survival

rate (EFS) 7%. On univariate analysis for survival, only pre-transplant chemosensitive relapse (_P_ < 0.05), serum albumin >3 g/dl (_P_ = 0.001), normal LDH (_P_ = 0.04), and long

interval between the second transplant and relapse/progression were significant beneficial factors. In a Cox proportional hazard model, chemosensitive relapse, and albumin >3 g/dl were

significant for better OS: hazard ratio (HR) 1.4, 1.7, respectively, while normal LDH, and absence of CA13 were significant for better EFS: HR 1.8, 1.7, respectively. Patients with albumin

>3 g/dl who had chemosensitive disease before ST (_n_ = 16) had a median survival of 16 months, compared to 7 months (_n_ = 34) and 2 months (_n_ = 26) for patients with only one (_n_ =

34) or no favorable prognostic factors (_n_ = 28), respectively (_P_ < 0.001). Their survival at 2 years post-ST was 43%, 17% and 11%, respectively. Our study suggests further

transplantation should only be considered in the setting of a clinical trial in patients with favorable prognostic factors. Access through your institution Buy or subscribe This is a preview

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PATIENTS WITH A LONG REMISSION AFTER AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION Article Open access 17 May 2024 THE ASSOCIATION OF MOBILISING REGIMEN ON IMMUNE RECONSTITUTION AND

SURVIVAL IN MYELOMA PATIENTS TREATED WITH BORTEZOMIB, CYCLOPHOSPHAMIDE AND DEXAMETHASONE INDUCTION FOLLOWED BY A MELPHALAN AUTOGRAFT Article 28 April 2021 OUTCOMES IN NEWLY DIAGNOSED YOUNG

OR HIGH-RISK MYELOMA PATIENTS RECEIVING TANDEM AUTOLOGOUS/ALLOGENEIC TRANSPLANT FOLLOWED BY BORTEZOMIB MAINTENANCE: A PHASE II STUDY Article 29 November 2021 REFERENCES * Selby PJ, McElwain

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* The Myeloma Institute for Research and Therapy, The University of Arkansas for Medical Sciences, Little Rock, AR, USA C-K Lee, B Barlogie, M Zangari, A Fassas, E Anaissie, C Morris, F van

Rhee, M Cottler-Fox, R Thertulien, F Muwalla, S Mazher & G Tricot * Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA A Badros Authors * C-K Lee View author

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* R Thertulien View author publications You can also search for this author inPubMed Google Scholar * F Muwalla View author publications You can also search for this author inPubMed Google

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ARTICLE Lee, CK., Barlogie, B., Zangari, M. _et al._ Transplantation as salvage therapy for high-risk patients with myeloma in relapse. _Bone Marrow Transplant_ 30, 873–878 (2002).

https://doi.org/10.1038/sj.bmt.1703715 Download citation * Received: 15 March 2002 * Accepted: 14 June 2002 * Published: 12 December 2002 * Issue Date: 01 December 2002 * DOI:

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currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * refractory myeloma * salvage transplantation