Retrospective survival analysis of multiple Myeloma patients after autologous hematopoietic stem cell transplantation

I. I. Kostroma, A. A. Zhernyakova, I. M. Zapreeva, Zh Yu Sidorova, N. Yu Semenova, E. V. Karyagina, E. I. Stepchenkova, S. S. Bessmeltsev, A. V. Chechetkin, S. V. Gritsaev

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background. Autologous hematopoietic stem cell transplantation (auto-HSCT) is an indispensable treatment stage in patients with newly diagnosed multiple myeloma (MM) who are, based on age and health status, eligible for highdose chemotherapy with subsequent auto-HSCT. However, the issue of double (tandem) auto-HSCT feasibility remains unresolved. Aim. To compare overall survival (OS) and progression-free survival (PFS) in MM patients after single and double (tandem) auto-HSCTs in clinical practice. Materials & Methods. Retrospective analysis enrolled 83 MM patients divided into two groups: with single (n = 41) and double (n = 42) auto-HSCTs. Median age in groups 1 and 2 was 58 years (range 42-68) and 54 years (range 40-65), respectively. In these groups there were 16 (39 %) and 11 (26.2 %) patients ≥ 60 years old. The reference point of survival curve was the date of fi rst (in group 1) and 2nd (in group 2) auto-HSCTs. In PFS assessment, completed event was the date of disease progression or relapse detection, including the biochemical one in case of specifi c therapy onset. Results. Total number of patients with ≥ very good partial response before receiving auto-HSCT in group 1 was 23 (56.1 %), and in group 2 before receiving 2nd auto-HSCT it was 30 (71.4 %). Mel200 conditioning was administered to 53.7 % of patients in group 1. In group 2 this conditioning regimen was a priority in performing fi rst auto-HSCT (83.3 % of patients) and was more rarely used in case of repeated transplantation (40.5 %). With median follow-up of 11 and 40.5 months in groups 1 and 2 no signifi cant diff erences were identifi ed either in median PFS (21 and 40 months; p = 0.154) or in median OS (not reached in both groups; p = 0.882). No diff erences between groups with respect to the time before relapse/progression or early relapse rate were observed. Conclusion. Repeated auto-HSCT showed no additional antitumor eff ect. It can be accounted for by the lack of data on chromosome aberrations at the disease onset in most patients and by a small number of patients in the groups. Nevertheless, it was decided to limit the number of tandem auto-HSCTs and to perform 2nd transplantation mostly in case of late relapse/progression. New studies were initiated which will focus on the search of predictors associated with survival improvement in MM patients while performing double (tandem) auto-HSCTs.

Original languageEnglish
Pages (from-to)73-79
Number of pages7
JournalKlinicheskaya Onkogematologiya/Clinical Oncohematology
Volume14
Issue number1
DOIs
StatePublished - 2021

Scopus subject areas

  • Hematology
  • Oncology

Keywords

  • Autologous hematopoietic stem cell transplantation
  • Double (tandem) auto-HSCTs
  • Multiple myeloma
  • Single auto-HSCT
  • Survival

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