Which Patients With Myeloma Benefit From Autologous Stem Cell Transplantation?
Posted: Wednesday, April 1, 2020
Autologous stem cell transplantation appears to be associated with durable responses and prolonged survival in a subgroup of patients with multiple myeloma—regardless of the type of induction therapy and/or use of maintenance therapy—according to a study that included almost three decades of data from The University of Texas MD Anderson Cancer Center, Houston. The study results were presented at the 2020 Transplantation & Cellular Therapy Meetings of the American Society for Transplantation and Cellular Therapy (Abstract 356).
“Duration of remission after transplant is the strongest predictor for long-term survival,” stated Samer A. Srour, MD, of the MD Anderson Cancer Center, and colleagues. “An age of less than 65 years, being African American, and standard-risk cytogenetics were also associated with surviving more than 10 years.”
The retrospective study included 1,409 patients who underwent their first autologous stem cell transplantation at MD Anderson between 1988 and 2015 and were followed for a minimum of 10 years. Patients were considered either long-term survivors (n = 392) or short-term survivors (n = 1,017; those who died within 10 years of diagnosis).
A higher percentage of patients in the long-term survivor group were younger than age 65 (86%); exhibited International Staging System stage 1 disease (47%), had standard-risk cytogenetics (96%), normal lactate dehydrogenase levels (88%), and daily serum creatinine levels below 2 mg (87%) at baseline. The majority of long-term survivors were relapse-free at 24 months after transplantation, compared with short-term survivors (76% vs. 32%). A total of 24% and 43% of patients in the long-term and short-term survivor groups, respectively, received proteasome inhibitor–based induction, with maintenance treatment not significantly associated with surviving for more than 10 years.
Disclosure: For full disclosures of the study authors, visit tct.confex.com.
