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Prognostic impact of early‐versus‐late responses to different induction regimens in patients with myeloma undergoing autologous hematopoietic cell transplantation: Results from the CALM study by the CMWP of the EBMT
Author(s) -
Garderet Laurent,
Sbianchi Giulia,
Iacobelli Simona,
Blaise Didier,
Byrne Jenny L.,
Remenyi Peter,
Apperley Jane F.,
Touzeau Cyrille,
Isaksson Cecilia,
Browne Paul,
Mayer Jiri,
Lenhoff Stig,
Gonzalez Muniz Soledad,
Parody Porras Rocio,
Basak Grzegorz,
Poire Xavier,
Trneny Marek,
Nagler Ar,
Michieli Mariagrazia,
Tanase Alina,
Koster Linda,
Hayden Patrick J.,
Beksac Meral,
Schönland Stefan,
YakoubAgha Ibrahim
Publication year - 2021
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.13602
Subject(s) - medicine , bortezomib , regimen , multiple myeloma , dexamethasone , oncology , cyclophosphamide , hematopoietic stem cell transplantation , thalidomide , autologous stem cell transplantation , transplantation , surgery , urology , chemotherapy
Background In autologous stem cell transplant (ASCT)‐eligible myeloma patients, prolonged induction does not necessarily improve the depth of response. Method We analyzed 1222 ASCT patients who were classified based on (a) the interval between induction and stem cell collection, (b) the type of induction regimen: BID (Bortezomib, IMiDs, and Dexamethasone), Bortezomib‐based, or CTD (Cyclophosphamide, Thalidomide, and Dexamethasone), and (c) the time to best response (Early ie, best response within 4 or 5 months, depending on the regimen vs Late; Good ie, VGPR or better vs Poor). Results The length of induction treatment required to achieve a Good response did not affect PFS ( P = .65) or OS ( P = .61) post‐ASCT. The three types of regimen resulted in similar outcomes: median PFS 31, 27.7 and 30.8 months ( P = .31), and median OS 81.7, 92.7, and 77.4 months, respectively ( P = .83). On multivariate analysis, neither the type nor the duration of the induction regimen affected OS and PFS, except for Early Good Responders who had a better PFS compared to Early Poor Responders (HR = 1.21, P ‐value = .02). However, achieving a Good response at induction was associated with a better response (≥VGPR) post‐transplant. Conclusion The kinetics of response did not affect outcomes.