Kastritis et al reviewed patients with myeloma who had an early relapse following autologous stem cell transplant. Early relapse is associated with a poor prognosis. The authors are from ATTIKO General University Hospital and Kapodistrian University of Athens.
Patient selection: multiple myeloma, status post autologous stem cell transplant
Early relapse was defined as relapse within (< 12) months after the transplant
Frequency in study: about 15%
Factors from multivariate analysis associated with early relapse:
(1) hypercalcemia (serum total calcium > 11 mg/dL)
(2) LDH greater than the upper limit of normal (ULN)
(3) not receiving post-transplant consolidation
(4) not receiving post-transplant maintenance therapy
Other factors that may contribute:
(1) eGFR < 30 mL per min per 1.73 square meter
(2) high risk cytogenetics
Observations:
(1) survival for this group is extremely poor despite use of modern agents
(2) patients who relapsed between 12 and 23.9 months had poor prognosis but not as bad as the ones who relapsed early
