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Post-ASCT Maintenance Therapy for Multiple Myeloma: A Canadian Perspective

By: Joshua D. Madera, MD
Posted: Monday, November 27, 2023

Maintenance therapy with bortezomib and lenalidomide after autologous stem cell transplantation (ASCT) may improve overall survival for patients with multiple myeloma, according to a study published in Blood Cancer Journal. However, additional investigative efforts are warranted to elucidate the benefit of this maintenance therapy in high-risk patients, suggested Julie Côté, MD, of CHU de Québec–Université Laval, Canada, and colleagues.

From 2007 to 2021, a total of 3,821 patients with multiple myeloma were retrospectively analyzed based on information from the Canadian Myeloma Research Group national database. All patients had received ASCT as first-line therapy. Patients who received induction therapy were eligible for participation in the study if they had ASCT after their treatment.

The study authors reported an overall survival of 126 months and a progression-free survival of 35.4 months in patients who received a single ASCT. Patients who received a second induction regimen with no associated maintenance therapy had worse outcomes (overall survival = 27.9 months; progression-free survival = 118 months). However, when maintenance therapy was used, the results were comparable. Furthermore, patients who received consolidation therapy demonstrated an extended median progression-free survival (55.3 months) compared with patients without consolidation therapy (34.4 months). No differences in overall survival were observed between these two patient groups. Patients who received lenalidomide-based maintenance therapy were found to have an overall survival of 159 months and a progression-free survival of 53.7 months. Moreover, the use of maintenance therapy, regardless of the type used, reduced the risk of disease progression (hazard ratio [HR] = 0.52) and death (HR = 0.58).

Disclosure: For full disclosures of the study authors, visit

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