Prognostic factors of 10-year survival in patients with myeloma after autologous stem cell transplantation: a multicenter retrospective analysis

Prognostic factors for long-term survival (LTS), defined as overall survival (OS) of ≥10 years, remain uncertain among patients with myeloma who undergo autologous stem cell transplantation (ASCT). We retrospectively analyzed 3650 patients with myeloma who underwent ASCT between 1994 and 2013 using the Japanese Society of Transplantation and Cellular Therapy registry. The proportion of long-term survivors was 28.7%. In logistic regression analyses, IgG-type, absence of high-risk cytogenetic abnormality (HRCA), International Staging System (ISS) I/II, and post-transplantation therapy were associated with LTS. Cox regression analysis revealed that kappa light chain type and post-transplantation therapy predicted better OS, whereas PS 2–4, HRCA, melphalan dose under 200 mg/m2, and ISS III predicted a shorter OS. We classified patients into three groups on the six significant factors; the estimated 10-year OS among the favorable group was 60.9%. ISS, HRCA, M-protein subtype, melphalan dose, achieving CR, and post-transplantation therapy were associated with LTS after ASCT.