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Comparative Study
. 2008 Oct;14(10):1134-1140.
doi: 10.1016/j.bbmt.2008.07.011.

Comparable outcomes in nonsecretory and secretory multiple myeloma after autologous stem cell transplantation

Shaji Kumar  1 , Waleska S Pérez  2 , Mei-Jie Zhang  2 , Karen Ballen  3 , Asad Bashey  4 , L Bik To  5 , Christopher N Bredeson  6 , Mitchell S Cairo  7 , Gerald J Elfenbein  8 , César O Freytes  9 , Robert Peter Gale  10 , John Gibson  11 , Robert A Kyle  1 , Martha Q Lacy  1 , Hillard M Lazarus  12 , Philip L McCarthy  13 , Gustavo A Milone  14 , Jan S Moreb  15 , Santiago Pavlovsky  14 , Donna E Reece  16 , David H Vesole  17 , Peter H Wiernik  18 , Parameswaran Hari  19
Affiliations
Comparative Study

Comparable outcomes in nonsecretory and secretory multiple myeloma after autologous stem cell transplantation

Shaji Kumar et al. Biol Blood Marrow Transplant. 2008 Oct.

Abstract

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.

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Figures

Figure 1
Figure 1
Demonstrates the progression free survival following single autologous stem cell transplantation in patients with non-secretory or secretory myeloma. No statistically significant difference is seen between the two groups (log rank test).
Figure 2
Figure 2
Demonstrates the overall survival following single autologous stem cell transplantation in patients with non-secretory or secretory myeloma. No statistically significant difference is seen between the two groups (log rank test).
Figure 3
Figure 3
Demonstrates the cumulative risk of treatment related mortality following single autologous stem cell transplantation in patients with non-secretory or secretory myeloma. No statistically significant difference is seen between the patient groups (log rank test).
See this image and copyright information in PMC

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