Year: 2018
Type: article
Study design: Observational Study
Abstract: Response rates in newly diagnosed multiple myeloma have improved dramatically with the introduction of highly effective novel therapies. However, survival in patients achieving optimal responses to initial treatment can vary significantly, and new prognostic indicators are required to improve risk stratification. We investigated the relationship between time to plateau (TPlat) and survival in 1099 newly diagnosed patients treated with novel agents at our institution from 2005 to 2015.TPlatwas defined as time from initiation of first‐line therapy to best response to first‐line therapy. The medianTPlatwas 4.9 months (0.7‐58.6) and plateau duration was 1.8 years (0.2‐11.0). Patients who required > 120 days to achieve a plateau had longer modified overall survival (mOS) and progression free survival (mPFS) calculated from a landmark of best response (P < .001 for both comparisons). Statistically significant improvement in mOS was retained in subgroup analysis based on age and whether patients received upfront autologous hematopoietic stem cell transplantation (ASCT) (P < .001 for all comparisons). Our results suggest that patients who respond more gradually to initial therapy (TPlat > 120 days) experience longer survival compared to more rapid responders. Patients with a prolongedTPlatcould represent an “ongoing responder” phenotype that portends a survival advantage independent of treatment with upfront ASCT, depth of response, and biologic markers such as ISS stage and cytogenetic risk.
Source: American Journal of Hematology
DOI: 10.1002/ajh.25113
Authors: Patrick W. Mellors, Moritz Binder, Francis K. Buadi, Martha Q. Lacy, Morie A. Gertz, Angela Dispenzieri, Suzanne R. Hayman, Prashant Kapoor, Wilson I. Gonsalves, Yi L. Hwa, Amie Fonder, Miriam Hobbs, Taxiarchis Kourelis, Rahma Warsame, Steven R. Zeldenrust, John A. Lust, Nelson Leung, Ronald S. Go, Robert A. Kyle, S. Vincent Rajkumar, Shaji K. Kumar
Institution: Mayo Clinic
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2799903558