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To define the role of autologous stem cell transplantation (ASCT) in newly diagnosed multiple myeloma (MM) in the era of novel agents, we analyzed follow-up data of patients treated by these agents alone or followed by ASCT. From January, 2008 to December, 2012, 136 patients with de novo MM, aged &lt;65 years, completed bortezomib- or thalidomide-based induction therapy and 114 patients achieved at least a partial response (PR). A total of 42 patients underwent ASCT. After a median follow-up of 39 months (range, 5-74 months), the median progression-free survival (PFS) was 23 months in the non-ASCT group vs. 42 months in the ASCT group (P=0.001), and the 5-year overall survival (OS) rate was 58.9 vs. 81.2%, respectively (P=0.03). The multivariate analysis revealed that complete response (CR) and maintenance therapy (MT) were independent factors of improved OS in both groups. Moreover, a subgroup analysis was performed according to the response status to evaluate the role of ASCT and MT. In the CR subgroup, neither ASCT nor MT exerted a significant effect on PFS or OS. In the very good PR subgroup, ASCT after MT (ASCT/MT) significantly improved PFS, but not OS. In patients exhibiting PR, ASCT/MT significantly prolonged PFS and OS. Therefore, ASCT in the era of novel agents maintains an important role in younger MM patients, particularly those achieving a PR after induction therapy. Furthermore, MT is a key factor associated with long-term survival in all MM patients.

molecular and clinical oncology

Novel agent induction therapy alone or followed by autologous stem cell transplantation in younger patients with multiple myeloma: A single-center retrospective study of 114 cases