Both progression-free and overall survival were significantly longer with high-dose melphalan plus stem-cell transplantation than with MPR ( median progression-free survival , @ months vs. @ months ; hazard ratio for progression or death , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P < @ ; and @-year overall survival , @ % vs. @ % ; hazard ratio for death , @ ; @ % CI , @ to @ ; P = @ ) .