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Sydney 2005:
Efficacy of a 2nd Transplant with a 1st ASCTResults from a Spanish PETHEMA/GEM Study
By Laura Rosinol, MD
Dr. Rosinol discussed the feasibility and efficacy of planned second transplant intensification in patients with MM. Those patients more likely to benefit from a second transplant are those failing initial transplant. More than 50% patients in whom tandem transplants were planned as the second transplant were not performed for multiple reasons, including disease progression or patient refusal. The remaining patients had a second transplant, either autologous transplant or mini-allogeneic transplant. Dose-reduced intensity allogeneic transplant after an autologous procedure resulted in a significantly higher CR rate than a second autologous intensification. Currently available follow-up data showed no significant differences in survival between the 2 modalities of second transplant (autologous or mini-allogeneic); EFS and OS were similar for both groups. Dr. Rosinol noted that EFS was better for those patients receiving a second transplant than for those who did not but cautioned that those patients who did not undergo the second transplant overall had a worse prognosis.

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