PROGNOSTIC FACTORS IN ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR MULTIPLE-MYELOMA

Purpose: To analyze prognostic factors for allogeneic bone marrow tran splantation (BMT) in multiple myeloma. Patients and Methods: One hundr ed sixty-two reports of allogeneic matched sibling-donor transplants i n multiple myeloma received by the European Group for Blood and Marrow Transplantation (EBMT) registry between 1983 and early 1993 were anal yzed for prognostic factors. End points were complete remission, survi val, and duration of complete remission. Results: Following BMT, 44% o f all patients and 60% of assessable patients entered complete remissi on. The overall actuarial survival rate was 32% at 4 years and 28% at 7 years. The overall relapse-free survival rate of 72 patients who wer e in complete remission after BMT was 34% at 6 years. Favorable pretra nsplant prognostic factors for survival were female sex (41% at 4 year s), stage I disease at diagnosis (52% at 4 years), one line of previou s treatment (42% at 4 years), and being in complete remission before c onditioning (64% at 3 years). The subtype immunoglobulin A (IgA) myelo ma and a low beta(2)-microglobulin lever (< 4 g/L) also tended to have a favorable prognostic impact. The most important posttransplant prog nostic factor was to enter a complete remission. Grade III to IV graft -versus-host disease (GVHD) was associated with poor survival. Conclus ion: Patients with a low tumor burden who respond to treatment before BMT and are transplanted after first-line therapy have the best progno sis following BMT. (C) 1995 by American Society of Clinical Oncology.