High-dose chemotherapy and autologous stem cell transplantation (ASCT) have provided effective treatment for patients with newly diagnosed multiple myeloma for more than 3 decades; however, which patients will benefit from tandem ASCT compared with single ASCT remains unclear. Here we retrospectively analyzed 978 trial and nontrial patients who underwent single or tandem ASCT in Heidelberg or other German-Speaking Myeloma Multicenter Group centers. Our results show that response improvement after first ASCT is a significant prognostic factor for progression-free survival benefit from tandem versus single ASCT (multivariable analysis, P = .002; hazard ratio, .64; 95% confidence interval, .48 to .85; P for interaction = .02). The depth of response after first ASCT and the cytogenetic profile did not have a significant prognostic effect on survival benefit from tandem ASCT. Our results suggest that it is not the response depth, but rather the response improvement after first ASCT is of prognostic significance regarding the benefit of tandem ASCT versus single ASCT.

大剂量化学疗法和自体干细胞移植（ASCT）为新诊断出的多发性骨髓瘤患者提供了有效的治疗已有超过30年的历史。然而，与单次ASCT相比，哪些患者将从串联ASCT中获益尚不清楚。在这里，我们回顾性分析了在海德堡或其他说德语的骨髓瘤多中心小组中心接受单次或串联ASCT的978名试验和非试验患者。我们的研究结果表明，首次ASCT后的反应改善是与单ASCT相比，串联治疗无进展生存的重要预后因素（多变量分析，P  = .002；危险比，.64； 95％置信区间，.48至.85 ；P互动= .02）。首次ASCT后的反应深度和细胞遗传学特征对串联ASCT的生存获益没有明显的预后影响。我们的结果表明，这不是反应深度，而是首次ASCT后的反应改善对串联ASCT相对于单个ASCT的益处具有预后意义。