Second Salvage Autologous Hematopoietic Stem Cell Transplantation in Patients with Relapsed/Refractory Multiple Myeloma in the Era of Novel Agents: Results of the KMM2301 Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Second salvage autologous stem cell transplantation (SAT) is a therapeutic option for patients with multiple myeloma (MM) who relapse after a first autologous stem cell transplantation (ASCT) in the era of novel agents. However, the clinical context in which SAT provides benefit relative to contemporary salvage regimens remains unclear. METHODS: We retrospectively analyzed 51 patients who underwent SAT after novel agent-based induction and first ASCT, and salvage re-induction, and compared outcomes with 113 patients treated with salvage carfilzomib-lenalidomide-dexamethasone (KRd) without SAT. RESULTS: Median interval from first ASCT to relapse was 27 months. In the SAT cohort, median progression-free survival (PFS) and overall survival (OS) from initiation of salvage therapy were 30 and 99 months, respectively. A time to relapse ≥18 months after first ASCT and receipt of SAT as second-line of therapy were associated with significantly longer PFS and OS. In multivariate analysis, administration of SAT at later lines was independently associated with inferior outcomes, while a time to relapse ≥18 months after first ASCT was associated with significantly longer OS. Compared with the KRd-only cohort, SAT was associated with longer OS, whereas PFS was numerically longer without statistical significance. Among patients who had received both a proteasome inhibitor and an immunomodulatory drug as salvage induction, SAT was associated with longer PFS and OS. CONCLUSIONS: SAT may provide clinical benefit in selected patients with MM, particularly those with a durable response to first ASCT and those undergoing SAT at an earlier line of relapse in the novel agent era.
Source: Cancers
Authors: Jongheon Jung, Ji Hyun Lee, Sung-Hyun Kim, Jae Hoon Lee, Kwai Han Yoo, Young Rok Do, Ho-jin Shin, Kihyun Kim, Sang Eun Yoon, Dok Hyun Yoon, Hyungwoo Cho, Hye Jin Kang, Ja Min Byun, Jae-Cheol Jo, Seung-Shin Lee, Won Sik Lee, Je-Jung Lee, Sung-Hoon Jung, Myung-Won Lee, Jun Ho Yi, Ju-Hyun Park, Chang-Ki Min, Hyeon-Seok Eom
Institutions: National Cancer Center, Gachon University, Dong-A University Hospital, Gachon University Gil Medical Center, Chonnam National University Hwasun Hospital, Dong-A University, Keimyung University Dongsan Medical Center, Keimyung University Dongsan Hospital, Pusan National University Hospital, Pusan National University, Samsung Medical Center, Sungkyunkwan University, Asan Medical Center, University of Ulsan, Korea Institute of Radiological and Medical Sciences, Seoul National University, Seoul National University Hospital, Ulsan University Hospital, Wonkwang University Hospital, Inje University Busan Paik Hospital, Chungnam National University, Chungnam National University Hospital, Chung-Ang University, Dongguk University, The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W7126164643