geneic transplant due to older age, comorbidities or lack of HLAidentical donor. Median age at transplant was 52 years (range 37-68), median interval between first and second autograft was 26 months (range 3-73). Eleven patients had persistent or progressive disease at transplant. Twenty patients received high-dose melphalan alone or in combination, while 2 received a combination of thiotepa, busulfan and cyclophosphamide. Patients had received an average of 6 prior chemotherapy regimens.

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... netic studies were available in 18/22 patients at the time of transplant, 12 were normal and 6 abnormal. Results: 14 of the 21 evaluable patients (70%) achieved a response (1 CR, 13 PR). After a median follow-up of 15 months (2-82), 1 year progression-free survival (PFS) was 40% and 1-year overall survival (OS) was 78%. 100-day TRM was 0%. Median PFS was 10 months, and median OS has not been reached. On univariate analysis, abnormal cytogenetics at transplant was a predictor of shorter overall survival (P ϭ .01). Conclusions: In patients with progressive disease after an autologous transplant, salvage autologous transplants may achieve responses in 70% of patients with durable remissions in a small subset. Normal cytogenetics at second transplant predicts a longer survival.