Autologous Stem Cell Transplantation in Multiple Myeloma in the Era of Novel Drug Induction: A Retrospective Single-Center Analysis.

Abstract

Within this retrospective single-center study, we analyzed the survival of 320 multiple myeloma (MM) patients receiving melphalan high-dose chemotherapy (HDCT) and either single (n = 286) or tandem (n = 34) autologous stem cell transplantation (ASCT) from 1996 to 2012. Additionally, the impact of novel induction regimens was assessed. Median follow-up was 67 months, median overall survival (OS) 62 months, median progression-free survival (PFS) 33 months (95% CI 27-39), and treatment-related death (TRD) 3%. Multivariate analysis revealed age ≥60 years (p = 0.03) and stage 3 according to the International Staging System (p = 0.006) as adverse risk factors regarding PFS. Median OS was significantly better in newly diagnosed MM patients receiving induction therapy with novel agents, e.g., bortezomib, thalidomide, or lenalidomide, compared with a traditional regimen (69 vs. 58 months; p = 0.01). More patients achieved at least a very good partial remission in the period from 2005 to 2012 than from 1996 to 2004 (65 vs. 30%; p < 0.001), with a longer median OS in the later period (71 vs. 52 months, p = 0.027). In conclusion, our analysis confirms HDCT-ASCT as an effective therapeutic strategy in an unselected large myeloma patient cohort with a low TRD rate and improved prognosis due to novel induction strategies.

• Authors: Gabriela B Thoennissen, Dennis Görlich, Ulrike Bacher, Thomas Aufenberg, Anne-Christin Hüsken, Anna Antonia Hansmeier, Georg Evers, Jan-Henrik Mikesch, Fleur Fritz, Carsten Bokemeyer, Carsten Müller-Tidow, Matthias Stelljes, Rolf M Mesters, Utz Krug, Martin H Kropff, Nils H Thoennissen, Wolfgang E Berdel
• Journal: Acta haematologica (Acta Haematol) Vol. 137 Issue 3 Pg. 163-172 ( 2017) ISSN: 1421-9662 [Electronic] Switzerland
• PMID: 28399522 (Publication Type: Journal Article)
• Copyright: © 2017 S. Karger AG, Basel.

Chemical References

• Antineoplastic Agents, Alkylating
• Melphalan

Topics

• Adult
• Aged
• Antineoplastic Agents, Alkylating (administration & dosage)
• Antineoplastic Protocols
• Cohort Studies
• Combined Modality Therapy
• Disease-Free Survival
• Female
• Humans
• Induction Chemotherapy
• Male
• Melphalan (administration & dosage)
• Middle Aged
• Multiple Myeloma (drug therapy, therapy)
• Prognosis
• Retrospective Studies
• Stem Cell Transplantation
• Transplantation, Autologous