AN UPDATE OF PROGNOSTIC FACTORS FOR ALLOGENEIC BONE-MARROW TRANSPLANTATION IN MULTIPLE-MYELOMA USING MATCHED SIBLING DONORS

Analysis of prognostic factors has been made in 369 allogeneic transpl ants for multiple myeloma reported to the registry of the European Gro up for Blood and Bone Marrow Transplantation (EBMT). Favorable prognos tic factors for obtaining a complete remission (CR) were stage I at di agnosis (CR 77%), one line of treatment before conditioning (CR 52%), CR before conditioning (CR 60%), and Ig A or light chain myeloma (CR 4 3% and 42%). Factors that predicted significantly for favorable surviv al in a univariate analysis included having received only one line of treatment, female sex, stage I at diagnosis, stage I at conditioning a nd a beta(2)-Microglobulin less than 4 mg/l. Favorable post-BMT factor s consisted of obtaining a CR following BMT and not being in graft-ver sus-host disease stage III or IV. A multivariate analysis of pre-BMT f actors showed that the sex of the patient and the number of lines of t reatment pretransplant were independent prognostic factors. Allogeneic BMT is a promising treatment method for patients who have received on ly one line of treatment, particularly if they are of the female sex. BMT late in the course of the disease is usually unsuccessful.