Conditioning regimens in autologous stem cell transplantation for multiple myeloma: a comparative study of efficacy and toxicity from the Spanish Registry for Transplantation in Multiple Myeloma

• DOI: 10.1046/j.1365-2141.2000.01979.x
• Publication Date: 2003-03-11T06:23:09Z
• Authors: Juan José Lahuerta; Joaquín Martinez‐...; Carlos Grande; Joan Bladé; Javier De La Serna; Adrián Alegre; José García‐Laraña; Dolores Caballero; Ana Sureda; Javier De La Rubia; Ana M. Alvarez; Julian Marín; Antonio Escudero; Eulogio Conde; Katy Perez‐Equiza; Juan C. García Ruiz; José M. Moraleda; Angel León; Juan Bargay; Rafael Cabrera; Miguel T. Hernand...; Joaquín Diaz‐Medi...; Jesús San Miguel
• Keywords: Autologous stem-cell transplantation; Hematology

High‐dose chemoradiotherapy conditioning regimens for autologous stem cell transplantation (ASCT) are generally held to give similar results in multiple myeloma (MM), but no specific comparative study has been published. We addressed this issue by comparing the main high‐dose used Spanish Registry. Patient cohorts included 315 cases treated with 200 mg/m 2 melphalan (MEL200), 127 patients 140 plus total body irradiation (MEL140 + TBI) and 121 12 mg/kg busulphan (BUMEL). After ASCT, granulocyte platelet recovery time was all groups. There were differences transplant‐related mortality . All yielded a response reference pre‐ASCT MM status, although BUMEL produced slightly better overall when compared other (97% vs. 89% 92%, P = 0·003). The 5‐year survival (OS) 47% [95% confidence interval (CI) 26–68] 43% (CI 31–54) MEL140 TBI 37% (CI: 18–56) MEL200. median group 64 months 45 37 MEL200 groups respectively. These non‐significant ( 0·2). event‐free (EFS) (32 months) than (22 or (20 months). EFS between reached statistical significance 0·01). Nevertheless, adjusted multivariate analysis OS revealed that had independent prognostic value. concluded three different regimens, commonly ASCT MM, have antimyeloma effect. However, trend observed our series requires prospective trial.