000157227 001__ 157227 000157227 005__ 20240917143639.0 000157227 0247_ $$2doi$$a10.1038/s41375-020-0948-0 000157227 0247_ $$2pmid$$apmid:32694619 000157227 0247_ $$2ISSN$$a0887-6924 000157227 0247_ $$2ISSN$$a1476-5551 000157227 0247_ $$2altmetric$$aaltmetric:86233320 000157227 037__ $$aDKFZ-2020-01497 000157227 041__ $$aeng 000157227 082__ $$a610 000157227 1001_ $$aGoldschmidt, Hartmut$$b0 000157227 245__ $$aSalvage autologous transplant and lenalidomide maintenance vs. lenalidomide/dexamethasone for relapsed multiple myeloma: the randomized GMMG phase III trial ReLApsE. 000157227 260__ $$aLondon$$bSpringer Nature$$c2021 000157227 3367_ $$2DRIVER$$aarticle 000157227 3367_ $$2DataCite$$aOutput Types/Journal article 000157227 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1726576585_15212 000157227 3367_ $$2BibTeX$$aARTICLE 000157227 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000157227 3367_ $$00$$2EndNote$$aJournal Article 000157227 500__ $$a2021 Apr;35(4):1134-1144 000157227 520__ $$aThe role of salvage high-dose chemotherapy and autologous stem cell transplantation (sHDCT/ASCT) for relapsed and/or refractory multiple myeloma (RRMM) in the era of continuous novel agent treatment has not been defined. This randomized, open-label, phase III, multicenter trial randomized patients with 1st-3rd relapse of multiple myeloma (MM) to a transplant arm (n = 139) consisting of 3 Rd (lenalidomide 25 mg, day 1-21; dexamethasone 40 mg, day 1, 8, 15, and 22; 4-week cycles) reinduction cycles, sHDCT (melphalan 200 mg/m2), ASCT, and lenalidomide maintenance (10 mg/day) or to a control arm (n = 138) of continuous Rd. Median PFS was 20.7 months in the transplant and 18.8 months in the control arm (HR 0.87; 95% CI 0.65-1.16; p = 0.34). Median OS was not reached in the transplant and 62.7 months in the control arm (HR 0.81; 95% CI 0.52-1.28; p = 0.37). Forty-one patients (29%) did not receive the assigned sHDCT/ASCT mainly due to early disease progression, adverse events, and withdrawal of consent. Multivariate landmark analyses from the time of sHDCT showed superior PFS and OS (p = 0.0087/0.0057) in patients who received sHDCT/ASCT. 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