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Impact of induction treatment before autologous stem cell transplantation on long‐term outcome in patients with newly diagnosed multiple myeloma
Author(s) -
Gassiot Susanna,
Motlló Cristina,
Llombart Inuska,
Morgades Mireia,
González Yolanda,
GarciaCaro Montse,
Ribera JosepMaria,
Oriol Albert
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12869
Subject(s) - medicine , cohort , multiple myeloma , autologous stem cell transplantation , induction chemotherapy , transplantation , chemotherapy , surgery , clinical trial , oncology , progression free survival
Objective Clinical trials for patients with multiple myeloma (MM) using novel agent (NA)‐based regimens before autologous stem cell transplantation ( SCT ) have shown improvement in response rates and progression‐free survival ( PFS ); however they have failed to identify a significant overall survival ( OS ) benefit. The aim of this study was to analyze the potential impact of initial induction on the feasibility and outcome of subsequent treatment lines in a real clinical practice setting. Methods Patients with consecutive MM <70 years of age diagnosed between 1999 and 2009 were prospectively registered and classified as having received conventional chemotherapy induction regimens with new agents available at relapse ( CC cohort, 89 patients) or as treated with NAs upfront ( NA cohort, 65 patients). Results Patients in the NA cohort demonstrated a superior median PFS (2.8 years vs 1.6 years, P =.03) and also a median PFS from diagnosis to second progression (5.2 years vs 2.7 years, P =.003). After a median follow‐up of 7 years, clear differences in OS were observed (7.97 years in NA cohort compared to 3.35 years in CC cohort, P <.001). Conclusions New agent‐based first‐line induction treatments provide benefits in both PFS and beyond that point, contributing to a significant improvement in OS .