Cook G, et al. - Researchers assessed how time to progression (TTP) and overall survival was influenced by cytogenetics in patients with relapsed multiple myeloma enrolled in the Myeloma X trial. Patients were randomly assigned to salvage autologous stem cell transplantation (ASCT) or weekly cyclophosphamide post-re-induction therapy. In cytogenetic analysis performed at trial registration, t(4;14), t(14;16) and del(17p) were defined as high-risk. Improved TTP was achieved with ASCT vs cyclophosphamide at 76 months median follow-up, on which a detrimental influence of the presence of any single high-risk lesion was evident. Improved overall survival was also observed with ASCT, on which MYC rearrangement had a detrimental influence. Salvage ASCT was found beneficial, possibly even following second relapse in surviving patients.