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Outcome after autologous stem cell transplantation for multiple myeloma in patients with preceding plasma cell disorders
Author(s) -
Kumar Shaji K.,
Dingli David,
Lacy Martha Q.,
Dispenzieri Angela,
Hayman Suzanne R.,
Buadi Francis K.,
Rajkumar S. Vincent,
Litzow Mark R.,
Gertz Morie A.
Publication year - 2008
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2008.07069.x
Subject(s) - multiple myeloma , medicine , monoclonal gammopathy of undetermined significance , autologous stem cell transplantation , plasma cell , plasmacytoma , transplantation , oncology , gastroenterology , monoclonal , immunology , antibody , monoclonal antibody
Summary A third of patients with multiple myeloma (MM) have a preceding diagnosis of plasma cell proliferative disorder (PCPD), mostly monoclonal gammopathy of undetermined significance (MGUS), smoldering MM (SMM) or plasmacytoma. While autologous stem cell transplantation (SCT) improves survival in MM, it is not clear if patients with preceding PCPD have a different outcome. We identified 151 patients with preceding PCPD from among 804 patients undergoing SCT, and their outcomes were compared. The response rates, including complete responses, were similar between the groups. Patients with a preceding diagnosis of MGUS had longer time to progression (TTP; 27·5 months vs. 17·2 months, P = 0·01), and longer overall survival (OS) from transplant (80·2 months vs. 48·3 months, P = 0·03) compared to those with de novo myeloma. However no differences were seen among those with a preceding diagnosis of SMM or plasmacytoma in terms of TTP or OS from transplant when compared to those with de novo myeloma. Multivariate analysis indicated that the presence of MGUS prior to myeloma was prognostic for post‐transplant relapse independent of other known risk factors. Patients with pre‐existing MGUS prior to myeloma diagnosis have a better outcome following HDT, reflecting more indolent disease and a favourable biology than those presenting with de novo myeloma.