Multiple Myeloma Coverage from Every Angle

Long-Term Outcomes With Standard-of-Care Strategy in Multiple Myeloma

By: Vanessa A. Carter, BS
Posted: Friday, March 5, 2021

At the 2021 Transplantation & Cellular Therapies Meetings (TCT), Mahmoud Gaballa, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues presented their study’s long-term outcomes of patients with multiple myeloma who were treated with a combination strategy of induction therapy, autologous hematopoietic stem cell transplantation, melphalan conditioning, and lenalidomide maintenance therapy. Their findings reported that this approach was associated with a 5-year overall survival rate of 79% (Abstract 497).

“Our study illustrates that VRD induction, auto-HCT with Mel200, and lenalidomide maintenance is associated with very good outcomes in multiple myeloma patients,” the investigators commented, “...especially those with standard-risk cytogenetics and complete response as their best final response.”

The researchers focused on 187 patients with transplant-eligible multiple myeloma who were treated with the following combination strategy: induction therapy with bortezomib, lenalidomide, and dexamethasone (VRD), followed by autologous hematopoietic stem cell transplantation (auto-HCT) with melphalan at 200 mg/m2 (Mel200) conditioning, and single-agent lenalidomide maintenance therapy. A total of 15% of participants had high-risk cytogenetics at diagnosis.

A complete response and a very good partial response was achieved in 9.6% and 52.9% of patients, respectively. The median follow-up was 63.2 months, and 87.2% of individuals reached at least a very good partial response by their final post-transplant evaluation; 57.2% achieved a complete response. The median progression-free survival was 50 months, and the 5-year progression-free survival rate was 43.1%. The median overall survival was 101.7 months, and the 5-year overall survival rate was 79%.

Significantly worse progression-free and overall survival outcomes were associated with patients having high-risk cytogenetics. However, standard-risk cytogenetics and achieving complete response at the final follow-up were both correlated with better progression-free and overall survival outcomes.

Disclosure: For full disclosures of the study authors, visit

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