In a nutshell
This study evaluated the effectiveness of salvage autologous hematopoietic cell transplantation (ASCT) performed with stem cells obtained after previous transplantation in patients with relapsed multiple myeloma (MM). The data showed that salvage ASCT performed with stem cells remobilized after previous transplantation is a good treatment option in these patients.
Multiple myeloma (MM) is a type of cancer that comes from blood cells called plasma cells. Autologous hematopoietic cell transplantation (ASCT) is the standard of care in the treatment of eligible patients with MM. ASCT involves transplanting healthy stem cells from the same patient. A high number of patients with MM experience relapse (the tumor grows after treatment) or are refractory (not responsive to the treatment) to standard treatment.
AHSCT may be performed in patients relapsing after a previous ASCT. For those without an optimal dose of stored stem cells, remobilization is necessary. In stem cell remobilization, certain drugs are used to cause the movement of stem cells from the bone marrow into the blood. The stem cells can be collected and stored. However, the effectiveness of salvage ASCT performed with stem cells remobilized after a previous transplantation in patients with relapsed MM is unknown.
Methods & findings
This study involved 305 patients with MM that had relapsed. All patients previously underwent an ASCT. After disease progression, all patients went on to undergo stem cell remobilization and an ASCT was performed with the cells obtained during the remobilization. The average follow-up time was 31 months.
The average overall survival was 51 months. 76% of the patients were alive after 2 years and 52% were alive after 4 years.
The average survival without cancer worsening was 17 months. 39% of the patients were alive without cancer worsening after 2 years and 15% were alive without cancer worsening after 4 years.
Infections occurred in 50% of patients. 20 patients out of 303 (6.6%) developed a second cancer after an average of 34 months after the salvage ASCT.
The bottom line
This study concluded that salvage ASCT performed with stem cells remobilized after a previous transplantation is a good treatment option in patients with MM.
The fine print
This study looked back in time at medical records. This study only included patients who proceeded to a salvage ASCT and does not include data on how many patients there were with failed remobilization attempts.
Published By :
Bone Marrow Transplantation
Feb 15, 2022
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