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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

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
Authors
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.
Ewha Authors
문영철
SCOPUS Author ID
문영철scopus
Issue Date
2013
Journal Title
Bone Marrow Transplantation
ISSN
0268-3369JCR Link
Citation
Bone Marrow Transplantation vol. 48, no. 3, pp. 425 - 432
Indexed
SCI; SCIE; SCOPUS WOS scopus
Document Type
Article
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. © 2013 Macmillan Publishers Limited. All rights reserved.
DOI
10.1038/bmt.2012.164
Appears in Collections:
의과대학 > 의학과 > Journal papers
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