Impact of Pretransplant Therapy and Depth of Disease Response before Autologous Transplantation for Multiple Myeloma
Year: 2014
Type: article
Study design: Observational Study
Abstract: Patients with multiple myeloma (MM) who are eligible for autologous stem cell transplantation (ASCT) typically receive a finite period of initial therapy before ASCT. It is not clear if patients with suboptimal (less than a partial) response to initial therapy benefit from additional alternative therapy with intent to maximize pretransplant response. We identified 539 patients with MM who had an ASCT after having achieved less than a partial response (PR) to first-line induction chemotherapy between 1995 and 2010. These patients were then divided into 2 groups: those who received additional salvage chemotherapy before ASCT (n = 324) and those who had no additional salvage chemotherapy immediately before ASCT (n = 215). Additional pretransplant chemotherapy resulted in deepening responses in 68% (complete response in 8% and PR in 60%). On multivariate analysis there was no impact of pretransplant salvage chemotherapy on treatment-related mortality, risk for relapse, progression-free survival, or overall survival. In conclusion, for patients achieving less than a PR to initial induction therapy, including with novel agent combinations, additional pre-ASCT salvage chemotherapy improved the depth of response and pre-ASCT disease status but was not associated with survival benefit.
Authors: Ravi Vij, Shaji Kumar, Mei-Jie Zhang, Xiaobo Zhong, Jiaxing Huang, Angela Dispenzieri, Muneer H. Abidi, Jennifer M. Bird, César O. Freytes, Robert Peter Gale, Tamila L. Kindwall-Keller, Robert A. Kyle, Daniel J. Landsburg, Hillard M. Lazarus, Reinhold Munker, Vivek Roy, Manish Sharma, Dan T. Vogl, Baldeep Wirk, Parameswaran N. Hari
Institutions: Washington University in St. Louis, Mayo Clinic, Medical College of Wisconsin, Wayne State University, The Barbara Ann Karmanos Cancer Institute, University Hospitals Bristol NHS Foundation Trust, The University of Texas at San Antonio Health Science Center, South Texas Veterans Health Care System, Imperial College London, University of Virginia Health System, University of Virginia Medical Center, Abramson Cancer Center, University of Pennsylvania, University Hospitals Cleveland Medical Center, University Hospitals Seidman Cancer Center, Louisiana State University, Louisiana State University Health Sciences Center Shreveport, Mayo Clinic in Florida, Thomas Jefferson University, Stony Brook University Hospital, Stony Brook Medicine
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
Funders: National Marrow Donor Program, U.S. Department of Defense, Be The Match Foundation, Amgen, GlaxoSmithKline, Sanofi, WellPoint, Leukemia and Lymphoma Society, Fred Hutchinson Cancer Research Center, St. Baldrick's Foundation, Teva Pharmaceutical Industries, Ariad Pharmaceuticals, Celgene, HistoGenetics, Osiris Therapeutics, Tarix Pharmaceuticals, Therakos, University of Minnesota, Blue Cross and Blue Shield Association, University of Utah, StemCyte, Medical College of Wisconsin, Otsuka America Pharmaceutical, Sigma-Tau Pharmaceuticals, Seattle Genetics, Actinium Pharmaceuticals, Chimerix, Incyte, Otsuka America, Kiadis Pharma, Swedish Orphan Biovitrum, Medac, National Institutes of Health, Health Resources and Services Administration, Genentech, Terumo BCT, Onyx Pharmaceuticals, U.S. Navy, Allos Therapeutics, Takeda Oncology, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases
Awards: G1072197786, G1585145239, G1769371581, G2108949772, G2220088171, G2814340220, G317906537, G4298420724, G4930744573, G541973719, G5569911400, DEVELOPMENT OF MEDICAL TECHNOLOGY FOR CONTINGENCY RESPONSE TO MARROW TOXIC SUBSTANCE, G7506463667, G7685818843, G777363952, G8122066879, G8464307619, G8872364087, G8876996369, A Data Resource for Blood and Marrow Transplants and Adoptive Cellular Therapy Research
OpenAlex ID: W2001006211