Autologous stem cell transplantation in myeloma: The St. James's Hospital experience, 1997-2003

Background: High-dose treatment with a utologous stem cell transplantation (ASCT) has become the standard of care for patients with myeloma below the age of 65 years. Aims: We report an audit of 60 patients (median age: 52.5 years) who underwent ASCT in the National Bone Marrow Transplant centre in St James's Hospital in Dublin between 1997 and 2003 inclusive. Methods: Clinical and laboratory data were retrieved from patient medical records and hospital information management systems. Results: Thirty-six patients had IgG, 11 IgA, 1 IgD, 9 light chain and 3 non-secretory MM. Fifty-seven (95%) patients received anthracycline-corticosteroid combination chemotherapy prior to autografting. There was no transplant-related mortality (TRM). Complete (CR) and Partial Responses (PR) were seen in 16 (29.6%) and 29 (53.7%) of those evaluable (n=54 (90%)). The actuarial Progression-Free (PFS) and Overall Survival (OS) rates at five years are 13% and 55% respectively. Conclusion: Centre outcome is comparable to published international series and supports the use of ASCT in the treatment of this malignancy.