Results of high-dose therapy for 1000 patients with multiple myeloma: durable complete remissions and superior survival in the absence of chromosome 13 abnormalities

High-dose therapy (HDT) has increased complete remission (CR) rates and sur vival in multiple myeloma (MM). We now report on continuous CR (CCR) and as sociated prognostic factors in 1000 consecutive patients receiving melphala n-based tandem HDT. Five-year CCR was 52% among 112 CR patients without chr omosome 13(Delta 13) abnormalities and with beta-2-microglobulin less than or equal to 2.5 mg/L, C-reactive protein less than or equal to 4 mg/L, and pre-HDT standard chemotherapy less than or equal to 12 months. Of all 390 C R patients without Delta 13 abnormalities, 35% enjoyed 5-year CCR but none of 54 with Delta 13 abnormalities. Delta 13 abnormalities, present in overa ll 16%, reduced B-year event-free survival from 20% to 0% and overall survi val from 44% to 16% (both P < .0001). OR and a second HDT cycle applied wit hin 6 months both extended event-free and overall survival significantly, j ustifying further pursuit of HDT, especially toward curing non-Delta 13 MM. (C) 2000 by The American Society of Hematology.