Multiple myeloma patients with a long remission after autologous hematopoietic stem cell transplantation

• DOI: 10.1038/s41408-024-01062-2
• Publication Date: 2024-05-17T07:02:53Z
• Authors: Oren Pasvolsky; Zhongya Wang; Denái R. Milton; Mark R. Tanner; Qaiser Bashir; Samer Srour; Neeraj Saini; Paul Lin; Jeremy Ramdial; Yago Nieto; Guilin Tang; Partow Kebriaei; Yosra Aljawai; Hina N. Khan; Hans C. Lee; Christine Ye; Krina K. Patel; Sheeba K. Thomas; Robert Z. Orlowski; Elizabeth J. Shpall; Richard E. Champlin; Muzaffar H. Qazil...
• Keywords: Male; Adult; Medical Sciences; Bioinformatics; 610; Transplantation, Autologous; Article; Biomedical Informatics; 0302 clinical medicine; Medical Specialties; Medicine and Health Sciences; Humans; RC254-282; Aged; Retrospective Studies; Transplantation; Remission Induction; Hematopoietic Stem Cell Transplantation; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; Middle Aged; Treatment Outcome; Oncology; Female; Multiple Myeloma; Autologous

AbstractAutologous stem cell transplantation (autoHCT) is considered standard of care for newly diagnosed multiple myeloma (MM). Although most patients eventually progress after autoHCT, a small proportion achieve a durable response. In this retrospective study we included 1576 patients, 244 (15%) of whom were long-term responders (LTR), defined as having a progression-free survival (PFS) of ≥8 years after transplant. Patients in the LTR group were younger than the non-LTR group (median age 58.4 vs. 59.5 years; p = 0.012), less likely to have high-risk cytogenetics (4% vs. 14%; p < 0.001), more often had <50% bone marrow plasma cells (67% vs. 58%; p = 0.018) and R-ISS stage I disease (43% vs. 34%). More patients in the LTR group received post-transplant maintenance (63% vs. 52%; p = 0.002). Patients in the LTR group had higher rates of complete response (CR) at day100 (41% vs. 27%; p < 0.001) and at best post-transplant response (70% vs. 37%; p < 0.001), compared to the non-LTR group. Patients in the LTR groups had a median PFS of 169.3 months and the median overall survival (OS) had not been reached. The leading cause of death in the LTR was disease progression. In conclusion, 15% of patients in the cohort were LTR after upfront autoHCT, with distinct characteristics and a median PFS of more than 14 years.