{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T19:28:40Z","timestamp":1790450920662,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A second autologous stem\u2010cell transplantation (ASCT2) is considered for relapsed multiple myeloma (RMM) patients showing prolonged response after a first ASCT. However, given breakthrough treatments like anti\u2010CD38 and immunotherapy, its role remains debated. We conducted a real\u2010life study in 10 French centers (1996\u20132017) involving 267 RMM patients receiving ASCT2. The median age was 61 years, with 49% females. Most patients received melphalan 200\u2009mg\/m\u00b2 before ASCT2, with low early mortality (1%). Very good partial response or better (VGPR+) rate post ASCT2 was 78%. Post ASCT2, 48% received consolidation therapy\u00a0and 40% maintenance therapy. Median event\u2010free survival (EFS) after ASCT2 was 2.6 years (95% confidence interval [CI]: 2.3\u20132.8), and 2\u2010year EFS estimate was 63% (95% CI: 57\u201370). Median overall survival (OS) was 8.1 years (95% CI: 5.9\u2013NA), and 2\u2010year OS estimate was 92% (95% CI: 88\u201395). Multivariate analysis revealed that VGPR+ status and maintenance therapy post ASCT2 were associated with better EFS (hazard ratio [HR]: 0.6; 95% CI: 0.3\u20130.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.012 and HR: 0.4; 95% CI: 0.3\u20130.6, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively) and OS (HR: 0.4; 95% CI: 0.2\u20130.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.017 and HR: 0.2; 95% CI: 0.1\u20130.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively), while male sex correlated with poorer outcomes for EFS (HR: 2.5; 95% CI: 1.7\u20133.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and OS (HR: 2.7; 95% CI: 1.4\u20134.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). Overall, ASCT2 appeared efficient with low toxicity in RMM. Maintenance therapy was associated with extended EFS and OS, particularly in patients with VGPR+ status post ASCT2. These findings underscore ASCT2's potential in RMM when coupled with maintenance therapy in selected patients.<\/jats:p>","DOI":"10.1002\/hem3.106","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T15:10:56Z","timestamp":1722265856000},"source":"Crossref","is-referenced-by-count":5,"title":["Impact of second autologous stem\u2010cell transplantation at relapsed multiple myeloma: A French multicentric real\u2010life study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0852-1670","authenticated-orcid":false,"given":"Axel","family":"Andr\u00e9","sequence":"first","affiliation":[{"name":"Immuno\u2010Hematology Unit, Saint\u2010Louis University Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Montes","sequence":"additional","affiliation":[{"name":"Hematology Department Amiens\u2010Sud University 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