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For multiple myeloma patients who relapse after initial treatment with an autologous stem cell transplant, salvage treatment with a second autologous stem cell transplant appears to be safe and to produce response rates that are similar to other treatment options. These results were published in Cancer.

Multiple myeloma is a cancer of plasma cells, which are a special type of white blood cell that are part of the body’s immune system. Patients with multiple myeloma have increased numbers of abnormal plasma cells that may produce increased quantities of dysfunctional antibodies detectable in the blood and/or urine.

High-dose cancer treatment followed by a stem cell transplant may be used in the treatment of several types of hematologic cancers, including multiple myeloma. Stem cell transplants may use the patient’s own stem cells that were collected prior to cancer treatment (an autologous transplant) or stem cells donated by another person (an allogeneic transplant).

For multiple myeloma patients who relapse after initial treatment with an autologous stem cell transplant, the effects of a second (salvage) autologous transplant have been uncertain. To explore this question, researchers conducted a study among 44 myeloma patients (median age of 54) who had relapsed and been treated with a second autologous stem cell transplant. The interval between the first and second transplant ranged from two to 78 months (median interval was 2.6 years).

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Forty-one percent of patients received maintenance therapy after the second transplant.

  • Roughly one-quarter of the patients experienced severe (grade 3 or worse) non-blood-related side effects. There was one treatment-related death.
  • 11 percent of patients had a complete response or a near-complete response to salvage treatment, and 79% had a partial response.
  • Median time to progression after salvage treatment was just over a year. Overall survival was 2.6 years.

These results suggest that for selected myeloma patients, treatment of a relapse with a second autologous stem cell transplant is an option.

Reference: Shah N, Ahmed F, Bashir Q et al. Durable remission with salvage second autotransplants in patients with multiple myeloma. Cancer. Early online publication November 15, 2011.

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