An elective single autograft with high-dose melphalan: Single-center study of 451 patients

Bhawna Sirohi*, R. Powles, J. Mehta, C. Rudin, S. Kulkarni, C. Horton, R. Saso, S. Singhal, J. Treleaven

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


In all, 451 myeloma patients, 51% previously untreated, underwent elective single autotransplantation after 200 mg/m2 melphalan between 1985 and 2001 at the Royal Marsden Hospital. The therapy sequence was: Induction (vincristine, doxorubicin, methylprednisolone±cyclophosphamide), marrow or filgrastim-mobilized blood stem cell harvest, autograft, and interferon-α2b maintenance. A total of 27 (6%) died of transplant-related toxicity, all within 3 months. Complete or near-complete remission was seen in 59% with an overall response rate of 91%. Subsequent disease progression was seen in 285, and 17 died of unrelated causes. In all, 206 patients were alive at the last follow-up, 6 months to 17.7 years posttransplant (median 65 months); 122 without disease progression at 6 months to 17.7 years (median 58 months). The median overall (OS) and event-free (EFS) survivals were 5.9 and 2.4 years, with 10-year OS and EFS probabilities of 31.4 and 16.5%, respectively. In Cox analysis, it was seen that significantly longer OS occurred for patients who had β-2-microglobulin <3.5 mg/l (P<0.0001), age <60 years (P=0.001) and albumin ≥35 g/l (P=0.009). EFS was also longer if β-2-microglobulin was <3.5 mg/l (P=0.0056) and patients were <60 years of age (P=0.033). We conclude that with a single planned autograft, patients with myeloma have an excellent outcome.

Original languageEnglish (US)
Pages (from-to)19-24
Number of pages6
JournalBone Marrow Transplantation
Issue number1
StatePublished - Jul 2005


  • Melphalan 200 mg/m
  • Multiple myeloma
  • Single autotransplantation

ASJC Scopus subject areas

  • Transplantation
  • Hematology


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