Outcomes after delayed and second autologous stem cell transplant in patients with relapsed multiple myeloma
We evaluated the outcomes of 168 patients undergoing delayed or second autologous stem cell transplant (ASCT) for relapsed multiple myeloma (MM) from 2010 to 2019. Overall, 21% ( n = 35) patients had received a prior transplant and 69% ( n = 116) underwent transplant at first relapse. Overall, 27%...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2021-11, Vol.56 (11), p.2664-2671 |
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| creator | Lemieux, Christopher Muffly, Lori S. Iberri, David J. Craig, Juliana K. Johnston, Laura J. Lowsky, Robert Shiraz, Parveen Rezvani, Andrew R. Frank, Matthew J. Weng, Wen-Kai Meyer, Everett Shizuru, Judith A. Arai, Sally Liedtke, Michaela Negrin, Robert S. Miklos, David B. Sidana, Surbhi |
| description | We evaluated the outcomes of 168 patients undergoing delayed or second autologous stem cell transplant (ASCT) for relapsed multiple myeloma (MM) from 2010 to 2019. Overall, 21% (
n
= 35) patients had received a prior transplant and 69% (
n
= 116) underwent transplant at first relapse. Overall, 27% patients had high-risk cytogenetics and 15% had ISS stage III disease. Stem cell collection was performed after relapse in 72% and 35% of patients received maintenance therapy. Median PFS from salvage treatment and transplant were 28 and 19 months, respectively. Median OS from salvage treatment and transplant was 69 and 55 months. Multivariate analysis revealed that ASCT in first relapse was associated with superior PFS (HR 0.63,
p
= 0.03) and OS (HR 0.59,
p
= 0.04) compared to later lines of therapy. In addition, PFS of ≥36 months with prior therapy was associated with improved PFS (HR 0.62,
p
= 0.04) and OS (HR 0.41,
p
= 0.01). Ninety-five patients underwent delayed transplant at first relapse, median PFS and OS from start of therapy was 30 and 69 months, and median OS from diagnosis was 106 months. These data may serve as a guide when counseling patients undergoing ASCT for relapsed MM and provide a benchmark in designing clinical trials of transplantation/comparative treatments for relapsed MM. |
| doi_str_mv | 10.1038/s41409-021-01371-1 |
| format | Article |
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n
= 35) patients had received a prior transplant and 69% (
n
= 116) underwent transplant at first relapse. Overall, 27% patients had high-risk cytogenetics and 15% had ISS stage III disease. Stem cell collection was performed after relapse in 72% and 35% of patients received maintenance therapy. Median PFS from salvage treatment and transplant were 28 and 19 months, respectively. Median OS from salvage treatment and transplant was 69 and 55 months. Multivariate analysis revealed that ASCT in first relapse was associated with superior PFS (HR 0.63,
p
= 0.03) and OS (HR 0.59,
p
= 0.04) compared to later lines of therapy. In addition, PFS of ≥36 months with prior therapy was associated with improved PFS (HR 0.62,
p
= 0.04) and OS (HR 0.41,
p
= 0.01). Ninety-five patients underwent delayed transplant at first relapse, median PFS and OS from start of therapy was 30 and 69 months, and median OS from diagnosis was 106 months. These data may serve as a guide when counseling patients undergoing ASCT for relapsed MM and provide a benchmark in designing clinical trials of transplantation/comparative treatments for relapsed MM.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/s41409-021-01371-1</identifier><identifier>PMID: 34163014</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/67/1990/804 ; 692/699/1541/1990/804 ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Autografts ; Care and treatment ; Cell Biology ; Clinical trials ; Cytogenetics ; Disease-Free Survival ; Health services ; Hematology ; Hematopoietic Stem Cell Transplantation ; Humans ; Internal Medicine ; Medicine ; Medicine & Public Health ; Multiple myeloma ; Multiple Myeloma - therapy ; Multivariate analysis ; Neoplasm Recurrence, Local ; Patient outcomes ; Patients ; Public Health ; Retrospective Studies ; Salvage Therapy ; Stem cell transplantation ; Stem Cells ; Therapy ; Transplantation ; Transplantation, Autologous</subject><ispartof>Bone marrow transplantation (Basingstoke), 2021-11, Vol.56 (11), p.2664-2671</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Limited 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Nature Limited.</rights><rights>COPYRIGHT 2021 Nature Publishing Group</rights><rights>The Author(s), under exclusive licence to Springer Nature Limited 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c572t-fa9587ecfae16064f16664ca39b6b6284abf7853c9e641b390d33ec7c8088cef3</citedby><cites>FETCH-LOGICAL-c572t-fa9587ecfae16064f16664ca39b6b6284abf7853c9e641b390d33ec7c8088cef3</cites><orcidid>0000-0003-3246-4726 ; 0000-0002-6721-0358 ; 0000-0002-5644-2292 ; 0000-0003-3288-7614 ; 0000-0002-9887-6136</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34163014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lemieux, Christopher</creatorcontrib><creatorcontrib>Muffly, Lori S.</creatorcontrib><creatorcontrib>Iberri, David J.</creatorcontrib><creatorcontrib>Craig, Juliana K.</creatorcontrib><creatorcontrib>Johnston, Laura J.</creatorcontrib><creatorcontrib>Lowsky, Robert</creatorcontrib><creatorcontrib>Shiraz, Parveen</creatorcontrib><creatorcontrib>Rezvani, Andrew R.</creatorcontrib><creatorcontrib>Frank, Matthew J.</creatorcontrib><creatorcontrib>Weng, Wen-Kai</creatorcontrib><creatorcontrib>Meyer, Everett</creatorcontrib><creatorcontrib>Shizuru, Judith A.</creatorcontrib><creatorcontrib>Arai, Sally</creatorcontrib><creatorcontrib>Liedtke, Michaela</creatorcontrib><creatorcontrib>Negrin, Robert S.</creatorcontrib><creatorcontrib>Miklos, David B.</creatorcontrib><creatorcontrib>Sidana, Surbhi</creatorcontrib><title>Outcomes after delayed and second autologous stem cell transplant in patients with relapsed multiple myeloma</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>We evaluated the outcomes of 168 patients undergoing delayed or second autologous stem cell transplant (ASCT) for relapsed multiple myeloma (MM) from 2010 to 2019. Overall, 21% (
n
= 35) patients had received a prior transplant and 69% (
n
= 116) underwent transplant at first relapse. Overall, 27% patients had high-risk cytogenetics and 15% had ISS stage III disease. Stem cell collection was performed after relapse in 72% and 35% of patients received maintenance therapy. Median PFS from salvage treatment and transplant were 28 and 19 months, respectively. Median OS from salvage treatment and transplant was 69 and 55 months. Multivariate analysis revealed that ASCT in first relapse was associated with superior PFS (HR 0.63,
p
= 0.03) and OS (HR 0.59,
p
= 0.04) compared to later lines of therapy. In addition, PFS of ≥36 months with prior therapy was associated with improved PFS (HR 0.62,
p
= 0.04) and OS (HR 0.41,
p
= 0.01). Ninety-five patients underwent delayed transplant at first relapse, median PFS and OS from start of therapy was 30 and 69 months, and median OS from diagnosis was 106 months. These data may serve as a guide when counseling patients undergoing ASCT for relapsed MM and provide a benchmark in designing clinical trials of transplantation/comparative treatments for relapsed MM.</description><subject>631/67/1990/804</subject><subject>692/699/1541/1990/804</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Autografts</subject><subject>Care and treatment</subject><subject>Cell Biology</subject><subject>Clinical trials</subject><subject>Cytogenetics</subject><subject>Disease-Free Survival</subject><subject>Health services</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - therapy</subject><subject>Multivariate analysis</subject><subject>Neoplasm Recurrence, Local</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Public Health</subject><subject>Retrospective Studies</subject><subject>Salvage Therapy</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Therapy</subject><subject>Transplantation</subject><subject>Transplantation, 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after delayed and second autologous stem cell transplant in patients with relapsed multiple myeloma</title><author>Lemieux, Christopher ; Muffly, Lori S. ; Iberri, David J. ; Craig, Juliana K. ; Johnston, Laura J. ; Lowsky, Robert ; Shiraz, Parveen ; Rezvani, Andrew R. ; Frank, Matthew J. ; Weng, Wen-Kai ; Meyer, Everett ; Shizuru, Judith A. ; Arai, Sally ; Liedtke, Michaela ; Negrin, Robert S. ; Miklos, David B. ; Sidana, Surbhi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-fa9587ecfae16064f16664ca39b6b6284abf7853c9e641b390d33ec7c8088cef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>631/67/1990/804</topic><topic>692/699/1541/1990/804</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Autografts</topic><topic>Care and treatment</topic><topic>Cell Biology</topic><topic>Clinical trials</topic><topic>Cytogenetics</topic><topic>Disease-Free Survival</topic><topic>Health services</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multiple myeloma</topic><topic>Multiple Myeloma - therapy</topic><topic>Multivariate analysis</topic><topic>Neoplasm Recurrence, Local</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Public Health</topic><topic>Retrospective Studies</topic><topic>Salvage Therapy</topic><topic>Stem cell transplantation</topic><topic>Stem Cells</topic><topic>Therapy</topic><topic>Transplantation</topic><topic>Transplantation, Autologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lemieux, Christopher</creatorcontrib><creatorcontrib>Muffly, Lori S.</creatorcontrib><creatorcontrib>Iberri, David J.</creatorcontrib><creatorcontrib>Craig, 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Surbhi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes after delayed and second autologous stem cell transplant in patients with relapsed multiple myeloma</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><stitle>Bone Marrow Transplant</stitle><addtitle>Bone Marrow Transplant</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>56</volume><issue>11</issue><spage>2664</spage><epage>2671</epage><pages>2664-2671</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><abstract>We evaluated the outcomes of 168 patients undergoing delayed or second autologous stem cell transplant (ASCT) for relapsed multiple myeloma (MM) from 2010 to 2019. Overall, 21% (
n
= 35) patients had received a prior transplant and 69% (
n
= 116) underwent transplant at first relapse. Overall, 27% patients had high-risk cytogenetics and 15% had ISS stage III disease. Stem cell collection was performed after relapse in 72% and 35% of patients received maintenance therapy. Median PFS from salvage treatment and transplant were 28 and 19 months, respectively. Median OS from salvage treatment and transplant was 69 and 55 months. Multivariate analysis revealed that ASCT in first relapse was associated with superior PFS (HR 0.63,
p
= 0.03) and OS (HR 0.59,
p
= 0.04) compared to later lines of therapy. In addition, PFS of ≥36 months with prior therapy was associated with improved PFS (HR 0.62,
p
= 0.04) and OS (HR 0.41,
p
= 0.01). Ninety-five patients underwent delayed transplant at first relapse, median PFS and OS from start of therapy was 30 and 69 months, and median OS from diagnosis was 106 months. These data may serve as a guide when counseling patients undergoing ASCT for relapsed MM and provide a benchmark in designing clinical trials of transplantation/comparative treatments for relapsed MM.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>34163014</pmid><doi>10.1038/s41409-021-01371-1</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3246-4726</orcidid><orcidid>https://orcid.org/0000-0002-6721-0358</orcidid><orcidid>https://orcid.org/0000-0002-5644-2292</orcidid><orcidid>https://orcid.org/0000-0003-3288-7614</orcidid><orcidid>https://orcid.org/0000-0002-9887-6136</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0268-3369 |
| ispartof | Bone marrow transplantation (Basingstoke), 2021-11, Vol.56 (11), p.2664-2671 |
| issn | 0268-3369 1476-5365 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8715953 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | 631/67/1990/804 692/699/1541/1990/804 Antineoplastic Combined Chemotherapy Protocols - therapeutic use Autografts Care and treatment Cell Biology Clinical trials Cytogenetics Disease-Free Survival Health services Hematology Hematopoietic Stem Cell Transplantation Humans Internal Medicine Medicine Medicine & Public Health Multiple myeloma Multiple Myeloma - therapy Multivariate analysis Neoplasm Recurrence, Local Patient outcomes Patients Public Health Retrospective Studies Salvage Therapy Stem cell transplantation Stem Cells Therapy Transplantation Transplantation, Autologous |
| title | Outcomes after delayed and second autologous stem cell transplant in patients with relapsed multiple myeloma |
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