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We evaluated the clinical significance of prognostic factors including the International Staging System ( ISS ) and modified European Group for Blood and Marrow Transplantation response criteria in 1650 Japanese patients with multiple myeloma ( MM ) who underwent upfront single autologous stem cell transplantation ( ASCT ). We categorized patients into two treatment cohorts: pre‐novel agent era (1995–2006) and novel agent era (2008–2011). The combined percentage of pre‐ ASCT  complete response and very good partial response cases (463 of 988, 47%) significantly increased during the novel agent era compared with the pre‐novel agent era (164 of 527, 31%;  P  < 0.0001). The 2‐year overall survival ( OS ) rate of 87% during the novel agent era was a significant improvement relative to that of 82% during the pre‐novel agent era ( P  = 0.019). Although significant differences in  OS  were found among ISS stages during the pre‐novel agent era, no significant difference was observed between  ISS  I and  II  ( P  = 0.107) during the novel agent era. The factors independently associated with a superior  OS  were female gender ( P  = 0.002), a good performance status ( P  = 0.024), lower  ISS  ( P  < 0.001), pre‐ ASCT  response at least partial response ( P  < 0.001) and  ASCT  during the novel agent era ( P  = 0.017). These results indicate that the response rate and  OS  were significantly improved, and the  ISS  could not clearly stratify the prognoses of Japanese patients with  MM  who underwent upfront single  ASCT  during the novel agent era.

cancer science

Changing trends in prognostic factors for patients with multiple myeloma after autologous stem cell transplantation during the immunomodulator drug/proteasome inhibitor era