Single and Tandem Autologous Peripheral Blood Stem Cell Transplantation for Patients with Multiple Myeloma: A Korean Multicenter Retrospective Study.

High-dose therapy with autologous stem cell transplantation (ASCT) is now considered the standard of care in patients with multiple myeloma (MM). This retrospective case analysis evaluated the prognostic influence of pre-transplant characteristics, transplant modalities, and disease status at post ASCT on survival to define patients with better prognosis. A total of 269 MM patients (median age: 53 years) who were transplanted between 1997 and 2007 from 6 centers in Korea were analyzed. All patients received peripheral blood stem cell support after conditioning with melphalan 140 mg/m² or 200 mg/m². In all, 190 patients received single ASCT and 79 patients received tandem ASCT. After a median follow-up of 28.5 months for surviving patients form single transplant, median progression-free survival (EFS) and overall survival (OS) were 19.2 months (95% CI, 15.9–22.6 months) and 71.3 months (95%CI, 56.9–85.7 months) with 18% and 55% probabilities of being progression-free and survival after 5 years, respectively. Treatment-related mortality within 90 days after ASCT was occurred in 12 patients (4.4%). Univariate analysis revealed that significant prognostic factor of PFS included age ≤ 50 at ASCT (p=0.024) and tandem ASCT (p<0.001). Significant prognostic factor for OS was tandem ASCT (p=0.029). The absence of unfavorable cytogenetic abnormalities was marginally significant for OS (p=0.074). In Cox analysis, it was seen that significantly longer PFS occurred for patients who received tandem ASCT (p=0.002). Age ≤ 50 at the time of ASCT was marginally significant prolonged PFS (p=0.054). Tandem ASCT independently correlated with better OS (p=0.044). We conclude that tandem ASCT independently correlated with better PFS and OS.