Site Editors
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Friday, September 8, 2023
Research results published in the British Journal of Haematology add to the sparse data on the outcomes of young adults with newly diagnosed multiple myeloma who have undergone autologous hematopoietic stem cell transplantation (HCT). According to Muzaffar H. Qazilbash, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues, depth of response after transplantation remains a key predictor of survival in this population of younger (up to age 40) patients.
These patients “had durable survival after autologous HCT, which further improved after the availability of novel antimyeloma drugs in recent years,” specifically in induction regimens, stated the team. Regimens containing immunomodulatory drugs and proteasome inhibitors are superior to those with chemotherapy alone, they noted. Also, maintenance therapy after transplantation has become widespread since 2010.
The single-center analysis included 117 patients treated between 1989 and 2012: 61 patients before 2010 and 56 patients from 2010 or later. Their median age was 37 years (range, 22–40 years) at transplantation, and 15% had high-risk cytogenetics. Prior to transplantation, 10% of patients had achieved a complete response or better, and 44% had achieved a very good partial response or better.
“At best post-transplant response, 56% and 77% of patients achieved a complete response or better and a very good partial response or better, respectively,” noted Dr. Qazilbash and co-investigators. Multivariate analysis indicated that achieving a complete response or better was associated with improved progression-free survival (P = .032), and achieving a very good partial response or better was predictive of superior overall survival (P < .001).
Additionally, patients who underwent autologous HCT in 2010 or later had better median progression-free survival (84.9 months vs. 28.2 months; P < .001) and overall survival (not reached vs. 91.8 months; P < .001) compared with those who received transplantation earlier. Overall, the median follow-up was 72.6 months, and the median progression-free survival and overall survival were 43.1 months and 146.6 months, respectively.
Disclosure: The study authors reported no conflicts of interest.
British Journal of Haematology
