1. 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
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Garderet L, Sbianchi G, Iacobelli S, Blaise D, Byrne JL, Remenyi P, Apperley JF, Touzeau C, Isaksson C, Browne P, Mayer J, Lenhoff S, Gonzalez Muniz S, Parody Porras R, Basak G, Poire X, Trneny M, Nagler A, Michieli M, Tanase A, Koster L, Hayden PJ, Beksac M, Schönland S, and Yakoub-Agha I
- Subjects
- Antineoplastic Combined Chemotherapy Protocols adverse effects, Duration of Therapy, Humans, Multiple Myeloma diagnosis, Multiple Myeloma mortality, Prognosis, Remission Induction, Time Factors, Transplantation, Autologous, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation adverse effects, Hematopoietic Stem Cell Transplantation methods, Multiple Myeloma therapy
- Abstract
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., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2021
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