{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T19:28:38Z","timestamp":1790450918917,"version":"4.1.0"},"reference-count":16,"publisher":"American Society of Hematology","issue":"16","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4,17]]},"abstract":"<jats:sec>\n                  <jats:title>Abstract<\/jats:title>\n                  <jats:p>The multicenter, phase 3 German-Speaking Myeloma Multicenter Group (GMMG) ReLApsE trial randomized patients with relapsed and\/or refractory multiple myeloma (RRMM) equally to lenalidomide\/dexamethasone (LEN\/DEX; 25 mg days 1-21, DEX\u00a040 mg weekly, in 4-week cycles) reinduction, salvage high-dose chemotherapy (sHDCT; melphalan 200 mg\/m2), autologous stem cell transplantation (ASCT), and LEN maintenance (10 mg\/d; transplant arm, n\u00a0=\u00a0139) vs continuous LEN\/DEX (control arm, n\u00a0=\u00a0138). Ninety-four percent of patients had received frontline HDCT\/ASCT. We report an updated analysis of survival end points with a median follow-up of 99 months. Median progression-free survival (PFS) was 20.5 and 19.3 months in the transplant and control arm, respectively (hazard ratio [HR], 0.98; P\u00a0=\u00a0.9). Median overall survival (OS) was 67.1 and 62.7 months, respectively, (HR 0.89; P\u00a0=\u00a0.44). Landmark analyses from sHDCT and the contemporaneous LEN\/DEX cycle 5 were performed because of 29% dropout of patients before sHDCT\/ASCT in the transplant arm but did not reveal significant differences in PFS\/OS. Time to progression after frontline HDCT\/ASCT was a prognostic factor but did not predict benefit from sHDCT\/ASCT. The GMMG ReLApsE trial does not support use of sHDCT\/ASCT in RRMM after frontline HDCT\/ASCT. This trial was registered at www.clinicaltrialsregister.eu as #EudraCT2009-013856-61.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1182\/blood.2024027342","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T21:57:08Z","timestamp":1736891828000},"page":"1780-1787","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":21,"title":["Salvage autologous transplant in relapsed multiple myeloma: long-term follow-up of the phase 3 GMMG ReLApsE trial"],"prefix":"10.1182","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4000-6904","authenticated-orcid":false,"given":"Marc-Andrea","family":"Baertsch","sequence":"first","affiliation":[{"name":"1Heidelberg Myeloma Center and GMMG Study Group, Department of Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg, Germany"},{"name":"2Clinical Cooperation Unit Molecular Hematology\/Oncology, German Cancer Research Center, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Schlenzka","sequence":"additional","affiliation":[{"name":"1Heidelberg Myeloma Center and GMMG Study Group, Department of Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hielscher","sequence":"additional","affiliation":[{"name":"3Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4181-6922","authenticated-orcid":false,"given":"Marc S.","family":"Raab","sequence":"additional","affiliation":[{"name":"1Heidelberg Myeloma Center and GMMG Study Group, Department of Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg, Germany"},{"name":"2Clinical Cooperation Unit Molecular Hematology\/Oncology, German Cancer Research Center, Heidelberg, Germany"},{"name":"4National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Sauer","sequence":"additional","affiliation":[{"name":"1Heidelberg Myeloma Center and GMMG Study Group, Department of Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2805-5973","authenticated-orcid":false,"given":"Maximilian","family":"Merz","sequence":"additional","affiliation":[{"name":"5Department of Hematology, Cell Therapy, Hemostaseology and Infectiology, Leipzig University Hospital, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6226-1252","authenticated-orcid":false,"given":"Elias Karl","family":"Mai","sequence":"additional","affiliation":[{"name":"1Heidelberg Myeloma Center and GMMG Study Group, Department of Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-5232","authenticated-orcid":false,"given":"Carsten","family":"M\u00fcller-Tidow","sequence":"additional","affiliation":[{"name":"1Heidelberg Myeloma Center and GMMG Study Group, Department of Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg, Germany"},{"name":"4National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Luntz","sequence":"additional","affiliation":[{"name":"6Coordination Centre for Clinical Trials, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Jauch","sequence":"additional","affiliation":[{"name":"7Institute for Human Genetics, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Brossart","sequence":"additional","affiliation":[{"name":"8Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, Medizinische Klinik und Poliklinik III, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Goerner","sequence":"additional","affiliation":[{"name":"9Department of Hematology, Oncology and Palliative Care, Community Hospital Bielefeld, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3351-6551","authenticated-orcid":false,"given":"Stefan","family":"Klein","sequence":"additional","affiliation":[{"name":"10Department of Hematology and Oncology, University Hospital Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Glass","sequence":"additional","affiliation":[{"name":"11Department of Hematology and Cellular Therapy, Helios Hospital Berlin-Buch, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Reimer","sequence":"additional","affiliation":[{"name":"12Department of Hematology, Oncology and Stem Cell Transplantation, Evangelische Kliniken Essen-Mitte, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ullrich","family":"Graeven","sequence":"additional","affiliation":[{"name":"13Department of Hematology, Oncology and Gastroenterology, Kliniken Maria Hilf GmbH, M\u00f6nchengladbach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Fenk","sequence":"additional","affiliation":[{"name":"14Department of Hematology, Oncology and Clinical Immunology, University of Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Haenel","sequence":"additional","affiliation":[{"name":"15Department of Hematology, Oncology and Stem Cell Transplantation, Klinikum Chemnitz GmbH, Chemnitz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"von Metzler","sequence":"additional","affiliation":[{"name":"16Department of Hematology and Oncology, Goethe University, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9836-7932","authenticated-orcid":false,"given":"Hans W.","family":"Lindemann","sequence":"additional","affiliation":[{"name":"17Department of Hematology and Oncology, Katholisches Krankenhaus Hagen gem. GmbH, Hagen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6539-226X","authenticated-orcid":false,"given":"Christof","family":"Scheid","sequence":"additional","affiliation":[{"name":"18Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor-Wolfgang","family":"Blau","sequence":"additional","affiliation":[{"name":"19Internal Medicine III, Charit\u00e9 Campus Benjamin Franklin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans J.","family":"Salwender","sequence":"additional","affiliation":[{"name":"20Asklepios Tumorzentrum Hamburg, AK Altona and AK St. Georg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Noppeney","sequence":"additional","affiliation":[{"name":"21Department of Hematology, University Hospital Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britta","family":"Besemer","sequence":"additional","affiliation":[{"name":"22Department of Hematology, Hematology, Oncology, Immunology, and Rheumatology, University of Tuebingen, Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja C.","family":"Weisel","sequence":"additional","affiliation":[{"name":"23Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0961-0035","authenticated-orcid":false,"given":"Hartmut","family":"Goldschmidt","sequence":"additional","affiliation":[{"name":"1Heidelberg Myeloma Center and GMMG Study Group, Department of Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg, Germany"},{"name":"4National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"3","key":"2025041711215257100_bib1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.annonc.2020.11.014","article-title":"Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"32","author":"Dimopoulos","year":"2021","journal-title":"Ann Oncol"},{"issue":"12","key":"2025041711215257100_bib2","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.6004\/jnccn.2023.0061","article-title":"Multiple myeloma, version 2.2024, NCCN Clinical Practice Guidelines in Oncology","volume":"21","author":"Kumar","year":"2023","journal-title":"J\u00a0Natl Compr Cancer Netw"},{"issue":"12","key":"2025041711215257100_bib3","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1016\/j.bbmt.2015.09.016","article-title":"American Society of Blood and Marrow Transplant, European Society of Blood and Marrow Transplantation, Blood and Marrow Transplant Clinical Trials Network and International Myeloma Working Group consensus conference on salvage hematopoietic cell transplant","volume":"21","author":"Giralt","year":"2015","journal-title":"Biol Blood Marrow Transplant"},{"issue":"7","key":"2025041711215257100_bib4","doi-asserted-by":"crossref","first-page":"e340","DOI":"10.1016\/S2352-3026(16)30049-7","article-title":"The effect of salvage autologous stem-cell transplantation on overall survival in patients with relapsed multiple myeloma (final results from BSBMT\/UKMF Myeloma X Relapse [Intensive]): a randomised, open-label, phase 3 trial","volume":"3","author":"Cook","year":"2016","journal-title":"Lancet Haematol"},{"issue":"4","key":"2025041711215257100_bib5","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1038\/s41375-020-0948-0","article-title":"Salvage autologous transplant and lenalidomide maintenance vs. lenalidomide\/dexamethasone for relapsed multiple myeloma: the randomized GMMG phase III trial ReLApsE","volume":"35","author":"Goldschmidt","year":"2021","journal-title":"Leukemia"},{"key":"2025041711215257100_bib6","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1186\/s12885-016-2321-2","article-title":"Rationale and design of the German-Speaking Myeloma Multicenter Group (GMMG) trial ReLApsE: a randomized, open, multicenter phase III trial of lenalidomide\/dexamethasone versus lenalidomide\/dexamethasone plus subsequent autologous stem cell transplantation and lenalidomide maintenance in patients with relapsed multiple myeloma","volume":"16","author":"Baertsch","year":"2016","journal-title":"BMC Cancer"},{"issue":"29","key":"2025041711215257100_bib7","doi-asserted-by":"crossref","first-page":"3279","DOI":"10.1200\/JCO.2017.72.6679","article-title":"Lenalidomide maintenance after autologous stem-cell transplantation in newly diagnosed multiple myeloma: a meta-analysis","volume":"35","author":"McCarthy","year":"2017","journal-title":"J\u00a0Clin Oncol"},{"issue":"2","key":"2025041711215257100_bib8","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1056\/NEJMoa1411321","article-title":"Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma","volume":"372","author":"Stewart","year":"2015","journal-title":"N\u00a0Engl J Med"},{"issue":"14","key":"2025041711215257100_bib9","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1056\/NEJMoa1607751","article-title":"Daratumumab, lenalidomide, and dexamethasone for multiple myeloma","volume":"375","author":"Dimopoulos","year":"2016","journal-title":"N\u00a0Engl J Med"},{"issue":"10245","key":"2025041711215257100_bib10","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/S0140-6736(20)30734-0","article-title":"Carfilzomib, dexamethasone, and daratumumab versus carfilzomib and dexamethasone for patients with relapsed or refractory multiple myeloma (CANDOR): results from a randomised, multicentre, open-label, phase 3 study","volume":"396","author":"Dimopoulos","year":"2020","journal-title":"Lancet"},{"issue":"10292","key":"2025041711215257100_bib11","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1016\/S0140-6736(21)00592-4","article-title":"Isatuximab, carfilzomib, and dexamethasone in relapsed multiple myeloma (IKEMA): a multicentre, open-label, randomised phase 3 trial","volume":"397","author":"Moreau","year":"2021","journal-title":"Lancet"},{"issue":"4","key":"2025041711215257100_bib12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1056\/NEJMoa2303379","article-title":"Cilta-cel or standard care in lenalidomide-refractory multiple myeloma","volume":"389","author":"San-Miguel","year":"2023","journal-title":"N\u00a0Engl J Med"},{"issue":"suppl 16","key":"2025041711215257100_bib13","article-title":"Ciltacabtagene autoleucel vs standard of care in patients with functional high-risk multiple myeloma: CARTITUDE-4 subgroup analysis [abstract].","volume":"42","author":"Costa","year":"2024","journal-title":"J\u00a0Clin Oncol"},{"issue":"11","key":"2025041711215257100_bib14","first-page":"e816","article-title":"Ixazomib as consolidation and maintenance versus observation in patients with relapsed multiple myeloma eligible for salvage autologous stem-cell transplantation (Myeloma XII [ACCoRD]): interim analysis of a multicentre,\u00a0open-label, randomised, phase 3 trial","volume":"11","author":"Cook","year":"2024","journal-title":"Lancet\u00a0Haematol"},{"issue":"1","key":"2025041711215257100_bib15","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/ejh.13709","article-title":"Carfilzomib and dexamethasone maintenance following salvage ASCT in multiple myeloma: a randomised phase 2 trial by the Nordic Myeloma Study Group","volume":"108","author":"Gregersen","year":"2022","journal-title":"Eur J Haematol"},{"issue":"19","key":"2025041711215257100_bib16","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1200\/JCO.18.01006","article-title":"Patient-reported outcome results from the open-label, randomized phase III Myeloma X trial evaluating salvage autologous stem-cell transplantation in relapsed multiple myeloma","volume":"37","author":"Ahmedzai","year":"2019","journal-title":"J\u00a0Clin Oncol"}],"container-title":["Blood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ashpublications.org\/blood\/article-pdf\/145\/16\/1780\/2369499\/blood_bld-2024-027342-main.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ashpublications.org\/blood\/article-pdf\/145\/16\/1780\/2369499\/blood_bld-2024-027342-main.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T15:21:58Z","timestamp":1744903318000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/blood\/article\/145\/16\/1780\/535069\/Salvage-autologous-transplant-in-relapsed-multiple"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,17]]},"references-count":16,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2025,4,17]]}},"URL":"https:\/\/doi.org\/10.1182\/blood.2024027342","relation":{},"ISSN":["0006-4971","1528-0020"],"issn-type":[{"value":"0006-4971","type":"print"},{"value":"1528-0020","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,17]]}}}