Comparable outcomes in nonsecretory and secretory multiple myeloma after autologous stem cell transplantation. Biol Blood Marrow Transplant 2008 Oct;14(10):1134-1140
Date
09/23/2008Pubmed ID
18804043Pubmed Central ID
PMC2634851DOI
10.1016/j.bbmt.2008.07.011Scopus ID
2-s2.0-51649085303 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
Nonsecretory myeloma (NSM) accounts for <5% of cases of multiple myeloma (MM). The outcome of these patients following autologous stem cell transplantation (ASCT) has not been evaluated in clinical trials. We compared the outcomes after ASCT for patients with NSM reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between 1989 and 2003, to a matched group of 438 patients (4 controls for each patient) with secretory myeloma (SM). The patients were matched using propensity scores calculated using age, Durie-Salmon stage, sensitivity to pretransplant therapy, time from diagnosis to transplant, and year of transplant. Disease characteristics were similar in both groups at diagnosis and at transplant except higher risk of anemia, hypoalbuminemia, and marrow plasmacytosis (in SM) and plasmacytoma (more in NSM). Cumulative incidence of treatment-related mortality (TRM), relapse, progression-free survival (PFS), and overall survival (OS) were similar between the groups. In multivariate analysis, based on a Cox model stratified on matched pairs and adjusted for covariates not considered in the propensity score, we found no difference in outcome between the NSM and SM groups. In this large cohort of patients undergoing ASCT, we found no difference in outcomes of patients with NSM compared to those with SM.
Author List
Kumar S, PĂ©rez WS, Zhang MJ, Ballen K, Bashey A, To LB, Bredeson CN, Cairo MS, Elfenbein GJ, Freytes CO, Gale RP, Gibson J, Kyle RA, Lacy MQ, Lazarus HM, McCarthy PL, Milone GA, Moreb JS, Pavlovsky S, Reece DE, Vesole DH, Wiernik PH, Hari PAuthors
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of WisconsinMei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAnalysis of Variance
Hematopoietic Stem Cell Transplantation
Humans
Middle Aged
Multiple Myeloma
Recurrence
Retrospective Studies
Survival Analysis
Transplantation, Autologous
Treatment Outcome