Relation between harvest success and outcome after autologous peripheral blood stem cell transplantation in multiple...

We studied the prognostic influence of pretransplant characteristics on response and survival in 104 consecutive patients with multiple myeloma receiving uniform pretransplant treatment consisting of VAD regimen, stem cell mobilisation, harvesting, and conditioning with melphalan 200 mg/m2. At the time of peripheral blood stem cell transplantation (PBSCT), 11% of patients were in complete remission (CR), and 63% in partial remission (PR). We evaluated the influence of age, sex, pretransplant response, number of harvested CD34+ cells, number of infused CD34+ cells, splitting part of the harvest for succeeding transplants on overall (OS) and progression-free survival (PFS) times. Following PBSCT, 31% of the patients were in CR and 57% in PR. Median OS and PFS from transplantation were 67 and 36 months, respectively. Transplant-related mortality was 0%. The number of harvested CD34+ cells was the only variable that was prognostic for OS in univariate and multivariate analyses. None of the variables was prognostic for PFS, although pretransplant response was nearly significant. The procedure of splitting and saving part of the harvest thus reducing the number of cells in the graft had no influence on outcome measured as OS or PFS.