Assessment of the role of timing of second transplantation in multiple myeloma by multistate modeling

Our study focuses on the importance of appropriate statistical analysis and illustrates how use of the Cox model within a multistate framework may be applied to the assessment of the role of an intermediate event in the disease process. The study illustrates both mathematically and visually the improved survival resulting from undertaking an elective second transplantation in patients with myeloma as soon as medically prudent-usually within 3 to 6 months of the first transplantation.