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Impact of duration of induction therapy on survival in newly diagnosed multiple myeloma patients undergoing upfront autologous stem cell transplantation
Author(s) -
Chakraborty Rajshekhar,
Muchtar Eli,
Kumar Shaji K.,
Buadi Francis K.,
Dingli David,
Dispenzieri Angela,
Hayman Suzanne R.,
Hogan William J.,
Kapoor Prashant,
Lacy Martha Q.,
Leung Nelson,
Warsame Rahma,
Kourelis Taxiarchis,
Gonsalves Wilson,
Gertz Morie A.
Publication year - 2018
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.15244
Subject(s) - medicine , multiple myeloma , autologous stem cell transplantation , surgery , transplantation , confidence interval , hematopoietic stem cell transplantation , oncology
Summary The optimal duration of induction therapy (IT) in transplant‐eligible multiple myeloma (MM) patients in not well defined, resulting in a wide variation in clinical practice. The objective of our study was to determine whether the duration of IT in patients undergoing upfront autologous stem cell transplantation (ASCT) has an impact on progression‐free survival (PFS) in the era of proteasome inhibitors and immunomodulatory drugs. A total of 596 patients who underwent ASCT at Mayo Clinic between 2007 and 2014 were included. The patients were divided into two cohorts based on the duration of IT: IT ≤ 4 and IT > 4 months. At a median follow‐up of 54·5 months from ASCT, the median PFS in the IT ≤ 4 group was 28 months [95% confidence interval (CI), 25–33], compared to 26 months in the IT > 4 group (95% CI, 24–31) [ P = 0·605]. There was no significant difference in overall survival (OS) in the two groups ( P = 0·904). The lack of impact of IT duration on PFS and OS was consistent in subgroups with high‐risk features at diagnosis (International Staging System III or high‐risk cytogenetics) and different depths of pre‐transplant response [≥very good partial response (VGPR) and