Novel Three-Part Treatment Sequence in High-Risk Multiple Myeloma
A new study published in Blood Advances reports that bortezomib maintenance therapy may prevent disease progression after tandem autologous and allogeneic hematopoietic cell transplantation in patients with newly diagnosed high-risk multiple myeloma. In an institutional press release, Lead investigator Marco Mielcarek, MD, of the Fred Hutchinson Cancer Research Center, posed the question of whether allogeneic transplant as a second step stated in an institutional press release: “We should keep an open mind and consider allogeneic [donor] transplants followed by some form of maintenance therapy,” in this patient population.
The study enrolled 31 patients and 21 went on to receive bortezomib following the transplants. At a median follow-up of 51 months, the 2-year progression-free survival was 71%, and overall survival estimates for the group were 75%. The 4-year estimates of progression-free and overall survival were 52% and 61%, respectively. This benefit however was not seen in the seven patients who enrolled with relapsed or persistent disease. Dr. Mielcarek noted that as the researchers have tracked patients over the past couple of years, the relapse rate in this group appears to have stabilized and that he hopes this trend continues.
Although the long-lasting results are encouraging, follow-up is necessary. “Our take-home message is that [this protocol] should probably be looked at in a larger, prospective, and, ideally, randomized study,” Dr. Mielcarek concluded.