Autologous stem cell transplantation in multiple myeloma at Chris Hani Baragwanath Academic Hospital

Background: Autologous stem cell transplantation (ASCT) is the standard of care for multiple myeloma (MM), even in the era of novel therapeutic agents. Data regarding ASCT outcomes in MM is lacking in South Africa. Aim: To assess the impact of ASCT on MM at a public health facility. Setting: Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg. Methods: A retrospective analysis of MM patients who received ASCT over 19 years. Results: Fifty-one patients received ASCT as part of their treatment schedule. While 41 patients received a single transplantation, 10 patients underwent a salvage transplantation after relapsing. Most of the patients (74.5%) had a delayed transplantation. The median overall survival (OS) was 57 months for the entire group, 32 months in the early transplantation group and 58.5 months in the delayed transplantation group, with no statistical difference between the early and delayed groups (p = 0.12) and among the different International Staging System groups (p = 0.71). The median time for disease relapse after the first ASCT was 30 months. Conclusion: Autologous stem cell transplantation is an important consolidation treatment modality for MM in the South African public health sector as it prolongs survival. Greater access to novel agents during induction and relapse is advocated in the South African public health sector to further improve the outcomes that are currently seen with ASCT. Contribution: This study adds to the limited body of knowledge pertaining to ASCT in MM in the African continent.