BACKGROUND: Multiple Myeloma is a relatively rare disease in korea. Compared to other hematological malignancies, therapeutic progress has been slow. Recently, the outcome is improved with the introduction of high dose therapy with autotransplantation.
To evaluate the efficacy and toxicities of high dose therapy with autotransplantation in Korean myeloma patients, we analysed 23 cases from multicenters.
METHODS: Retrospective analysis of 23 patients was done. The outcome of 23 newly diagnosed (N=15) or refractory/relapsed (N=9) multiple myeloma patients who received autotransplantation were analysed for response rate, toxicities, progression free survival and overall survival. The variables affecting outcome were analysed using standard statistical methods.
RESULTS: Melphalan 200㎎/㎡ was used as a preparative regimen in most cases. The median numbers of infused mononuclear cells and CD34+ cells were 4.1×10 8/㎏ and 6.1×10 6 /㎏, respectively. Median durations of granulocyte nadir and platelet dependence were 6.5 days and 7 days. Infection and mucositis greater than grade 11 were observed in22% and 26%, respectively. Early death rate was 4%. All patients responded and 59% attained complete remission. Initial LDH was the only factor
affecting complete remission. With the median follow up of 9 month, 2.5 year cumulative progression free survival and overall survival of all patients after transplantation was 64±12% and 60±16%, respectively. In newly diagnosed patients, 2.5 year cumulative progression free survival and overall survival after transplant was 89±10% and 81±12%, respectively. Newly diagnosed patients, early transplant within 1 year and chemosensitivity were significant variables for progression free survival in univariate analysis. Among them, only chemosensitivity retains significance in multivariate analysis. Male and IgG were significant variables affecting overall survival in both univariate and multivariate analyses.
CONCLUSION : High dose therapy with autotransplantation is a safe and effective treatment in patients with multiple myeloma. Compared to published articles, we could not find any difference in Korean myeloma patients in terms of autotransplantation outcomes.

Keywords: Multiple myeloma, High dose therapy with autotransplantation, Korean, Multicenter