Salvage autologous stem-cell transplantation (ASCT) may improve the overall survival (OS) of patients with relapsed multiple myeloma treated with an initial ASCT, according to the overall results of a study recently published in The Lancet Haematology.1

Investigators of Myeloma X, a multicenter, randomized, open-label, phase 3 trial, found that ASCT improved time to disease progression, in contrast to oral cyclophosphamide, for patients with relapsed multiple myeloma. OS rates, however, were not initially published.

The authors write that of 89 patients assigned to receive salvage ASCT and high-dose melphalan, median OS was 67 months; median OS for the oral cyclophosphamide group, to which 85 patients were assigned, was 52 months (P = .0169).

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At extended follow-up, 7 patients in the ASCT group had second primary malignancies; this was observed in only 5 patients in the oral cyclophosphamide group.

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The authors conclude that salvage ASCT improves OS of patients with relapsed multiple myeloma, though ASCT should be performed during consolidation of re-induction treatment. Delay of ASCT treatment is not as advantageous.

No further adverse events were reported at extended follow-up.


1. Cook G, Ashcroft AJ, Cairns DA, et al. The effect of salvage autologous stem-cell transplantation on overall survival in patients with relapsed multiple myeloma (final results from BSBMT/UKMF Myeloma X Relapse [Intensive]): a randomised, open-label, phase 3 trial. Lancet Haematol. 3 Jul 2016. doi: 10.1016/S2352-3026(16)30049-7 [Epub ahead of print]