Efficacy and prognostic factors of autologous hematopoietic stem cell transplantation for multiple myeloma: clinical analysis of 53 cases

Abstract

Objective To evaluate the efficacy of autologous hematopoietic stem cell transplantation (auto-HSCT) on multiple myeloma (MM) and to investigate the factors affecting the prognosis. Methods The clinical data of 53 MM patients treated with auto-HSCT in our hospital from January 2010 to December 2019 were collected and retrospectively analyzed. The therapeutic effect was observed and the prognostic factors were analyzed. Results Hematopoietic reconstruction was achieved in all 53 patients, and no transplant-related death occurred. As complete remission (CR) and very good partial remission (VGPR) were defined as effective response, the rate was 84.9% after transplantation, significantly higher than that before treatment (52.8%)(P 0.05). Influential factors for poor prognosis were identified as: age≥50 years, stage Ⅲ by revised international staging system (R-ISS), time from diagnosis to transplantation ≥180 d, high-risk stratification, partial remission (PR) or worse before and after transplantation, as well as positive results of minimal residual disease (MRD) test before and after treatment. Conclusion Auto-HSCT is safe and effective in MM patients, and can significantly improve the remission rate and prognosis. Single transplantation is better than continuous double treatment in the effectiveness. R-ISS stage, risk stratification, disease status before and after transplantation, and result of MRD test are closely associated with the prognosis of the patients.

Keywords

• multiple myeloma
• autologous hematopoietic stem cell transplantation
• survival analysis
• prognostic factors