{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:56:22Z","timestamp":1790776582247,"version":"4.1.0"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>High-dose melphalan followed by autologous stem cell transplantation (ASCT) is standard in multiple myeloma (MM), but relapse remains inevitable. Second ASCT2 is a salvage option for selected patients with durable remission after ASCT1. Reports from the Asia-Pacific region are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study included six patients with relapsed MM who underwent ASCT2 between 2012 and 2025. Demographics, treatment characteristics, toxicity, engraftment, and outcomes were analyzed. All patients underwent fresh stem cell mobilization with granulocyte colony-stimulating factor and plerixafor without cryopreservation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The median age at ASCT2 was 61 years (range, 47\u201365 years). The median interval between ASCT1 and ASCT2 was 66 months (range, 31\u2013123 months). Two patients achieved partial remission (PR), 1 achieved very good partial remission (VGPR), and 3 achieved complete remission (CR) before ASCT2. Four patients received melphalan 140 mg\/m\u00b2 and 2 received melphalan 200 mg\/m\u00b2 for ASCT2. The median CD34\u207a cell dose infused during ASCT2 was 2.54 \u00d7 10\u2076\/kg (range, 1.42\u201321 \u00d7 10\u2076\/kg). Febrile neutropenia developed in 4 patients but was easily controlled with empiric antibiotics. Neutrophil recovery occurred at a median of 11 days (range, 10\u201314 days), and platelet recovery at 13 days (range, 12\u201315 days). Hospital stay duration ranged from 15 to 22 days, with a median of 18.5 days. There was no transplant-related mortality. The median follow-up of the study cohort was 28.5 months (range, 1\u201347 months). Two patients died at 35 and 47 months post-ASCT2, respectively, due to progressive disease. One patient was lost to follow-up after the second bone marrow transplant. Three patients remain alive and in sustained remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ASCT2 is a feasible salvage strategy in selected Indian patients with MM, yielding favorable outcomes with acceptable toxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijc.ijc_50_26","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:02:12Z","timestamp":1788537732000},"page":"186-190","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Second autologous hematopoietic stem cell transplantation in multiple myeloma"],"prefix":"10.4103","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3139-611X","authenticated-orcid":false,"given":"Disha","family":"Kakkar","sequence":"first","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplant, Artemis Hospital, Gurugram, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7553-0677","authenticated-orcid":false,"given":"Vivek","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplant, Artemis Hospital, Gurugram, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-5916","authenticated-orcid":false,"given":"Hamza","family":"Dalal","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplant, Fortis Institute of Blood Disorders, Fortis Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4167-8837","authenticated-orcid":false,"given":"Subhaprakash","family":"Sanyal","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplant, Fortis Institute of Blood Disorders, Fortis Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-8588","authenticated-orcid":false,"given":"Rahul","family":"Naithani","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplant, Artemis Hospital, Gurugram, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"R1-20260930","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1056\/NEJMoa2204925","article-title":"Triplet therapy, transplantation, and maintenance until progression in myeloma","volume":"387","author":"Richardson","year":"2022","journal-title":"N Engl J Med"},{"key":"R2-20260930","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.clml.2024.12.010","article-title":"Consolidation with second high dose therapy and autologous stem cell transplantation is associated with improved overall survival in patients with multiple myeloma in first relapse","volume":"25","author":"Klomberg","year":"2025","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"R3-20260930","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1007\/s00277-025-06262-9","article-title":"Is there still a place for autologous salvage transplantation in relapsed\/refractory multiple myeloma in the era of novel therapies?","volume":"104","author":"Karp","year":"2025","journal-title":"Ann Hematol"},{"key":"R4-20260930","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1038\/s41409-024-02460-7","article-title":"Satisfactory outcomes following a second autologous hematopoietic cell transplantation for multiple myeloma in poor stem cell mobilizers: A retrospective study on behalf of the chronic malignancies working party of the EBMT","volume":"60","author":"Sever","year":"2025","journal-title":"Bone Marrow Transplant"},{"key":"R5-20260930","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.1002\/hem3.106","article-title":"Impact of second autologous stem-cell transplantation at relapsed multiple myeloma: A French multicentric real-life study","volume":"8","author":"Andr\u00e9","year":"2024","journal-title":"Hemasphere"},{"key":"R6-20260930","doi-asserted-by":"crossref","first-page":"1611851","DOI":"10.3389\/pore.2024.1611851","article-title":"The efficacy and safety of second salvage autologous transplantation in myeloma patients","volume":"30","author":"Bicsko","year":"2024","journal-title":"Pathol Oncol Res"},{"key":"R7-20260930","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1038\/s41409-022-01592-y","article-title":"Autologous hematopoietic cell transplantation for relapsed multiple myeloma performed with cells procured after previous transplantation\u2013study on behalf of CMWP of the EBMT","volume":"57","author":"Drozd-Soko\u0142owska","year":"2022","journal-title":"Bone Marrow Transplant"},{"key":"R8-20260930","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1038\/s41375-020-1005-8","article-title":"Salvage second transplantation in relapsed multiple myeloma","volume":"35","author":"Dhakal","year":"2021","journal-title":"Leukemia"},{"key":"R9-20260930","doi-asserted-by":"crossref","first-page":"2664","DOI":"10.1038\/s41409-021-01371-1","article-title":"Outcomes after delayed and second autologous stem cell transplant in patients with relapsed multiple myeloma","volume":"56","author":"Lemieux","year":"2021","journal-title":"Bone Marrow Transplant"},{"key":"R10-20260930","first-page":"316","article-title":"Second stem cell transplantation for treatment of relapsed\/refractory multiple myeloma after first autologous stem cell transplant: A 15-year retrospective institutional analysis","volume":"60","author":"Yadav","year":"2023","journal-title":"Indian J Cancer"}],"container-title":["Indian Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.ijc_50_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:04:55Z","timestamp":1790773495000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.ijc_50_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijc.ijc_50_26","relation":{},"ISSN":["0019-509X","1998-4774"],"issn-type":[{"value":"0019-509X","type":"print"},{"value":"1998-4774","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-01-16","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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