TY - JOUR
T1 - Impact of autologous transplantation in patients with multiple myeloma with t(11;14)
T2 - A propensity-score matched analysis
AU - Saini, Neeraj
AU - Ma, Junsheng
AU - Milton, Denái R.
AU - Patel, Romil
AU - Varma, Ankur
AU - Bashir, Qaiser
AU - Delgado, Ruby
AU - Mukherjee, Akash
AU - Rondon, Gabriela
AU - Popat, Uday R.
AU - Hosing, Chitra M.
AU - Nieto, Yago
AU - Kebriaei, Partow
AU - Alousi, Amin M.
AU - Ahmed, Sairah
AU - Tang, Guilin
AU - Mehta, Rohtesh
AU - Srour, Samer
AU - Khouri, Issa F.
AU - Iyer, Swaminathan
AU - Weber, Donna M.
AU - Thomas, Sheeba K.
AU - Lee, Hans C.
AU - Manasanch, Elisabet E.
AU - Patel, Krina K.
AU - Orlowski, Robert Z.
AU - Champlin, Richard E.
AU - Qazilbash, Muzaffar H.
N1 - Publisher Copyright:
© 2019 American Association for Cancer Research.
PY - 2019/11/15
Y1 - 2019/11/15
N2 - Purpose: Patients with multiple myeloma with t(11;14) have been considered to have standard-risk disease. However, several recent reports have shown contradictory results. We identified 95 patients with multiple myeloma with t(11;14) on FISH studies, who underwent upfront autologous hematopoietic stem cell transplant (auto-HCT) at our center. We compared their outcome with a group of standard-risk patients with multiple myeloma who had diploid cytogenetics by both conventional cytogenetics (CC) and FISH (n ¼ 287). Experimental Design: To reduce the bias between the groups, we performed a 1:1 propensity score matching technique for analysis. A total of 160 patients, 80 in each group, were identified. Patients in the 2 groups were matched for age, International staging system stage at diagnosis, serum creatinine at presentation, disease status at auto-HCT, type of preparative regimens, dose of melphalan used for conditioning, and induction and maintenance regimens. Results: Patients in t(11;14) group had a post auto-HCT overall response rate (ORR) of 97.5% (78/80), compared with 100% (80/80) in the standard-risk control group (P ¼ 0.50). Complete response rate in the t(11;14) group was 35% (28/80), compared with 45% (36/80) in the standard-risk control group (P ¼ 0.26). The 4-year PFS rates were 40.8% (95% CI, 29.6%-56.1%) and 51.1% (95% CI, 39.4%-66.3%) in the t(11;14) and standard-risk control groups, respectively (P ¼ 0.14). The 4-year OS rates were 74.9% (95% CI, 63.3%-88.7%) and 88.3% (95% CI, 80.4%-97.0%) in the t(11;14) and standard-risk control groups, respectively (P ¼ 0.17). Also, patients with t(11;14) with concurrent cytogenetics had significantly poor PFS and OS compared with a propensity matched standard-risk control group. Conclusions: Our study confirms that t(11;14) multiple myeloma undergoing upfront autologous transplantation had similar outcomes as patients with multiple myeloma with normal cytogenetic and FISH studies. Existence of additional genomic aberrations by CC or FISH was associated with a worse outcome.
AB - Purpose: Patients with multiple myeloma with t(11;14) have been considered to have standard-risk disease. However, several recent reports have shown contradictory results. We identified 95 patients with multiple myeloma with t(11;14) on FISH studies, who underwent upfront autologous hematopoietic stem cell transplant (auto-HCT) at our center. We compared their outcome with a group of standard-risk patients with multiple myeloma who had diploid cytogenetics by both conventional cytogenetics (CC) and FISH (n ¼ 287). Experimental Design: To reduce the bias between the groups, we performed a 1:1 propensity score matching technique for analysis. A total of 160 patients, 80 in each group, were identified. Patients in the 2 groups were matched for age, International staging system stage at diagnosis, serum creatinine at presentation, disease status at auto-HCT, type of preparative regimens, dose of melphalan used for conditioning, and induction and maintenance regimens. Results: Patients in t(11;14) group had a post auto-HCT overall response rate (ORR) of 97.5% (78/80), compared with 100% (80/80) in the standard-risk control group (P ¼ 0.50). Complete response rate in the t(11;14) group was 35% (28/80), compared with 45% (36/80) in the standard-risk control group (P ¼ 0.26). The 4-year PFS rates were 40.8% (95% CI, 29.6%-56.1%) and 51.1% (95% CI, 39.4%-66.3%) in the t(11;14) and standard-risk control groups, respectively (P ¼ 0.14). The 4-year OS rates were 74.9% (95% CI, 63.3%-88.7%) and 88.3% (95% CI, 80.4%-97.0%) in the t(11;14) and standard-risk control groups, respectively (P ¼ 0.17). Also, patients with t(11;14) with concurrent cytogenetics had significantly poor PFS and OS compared with a propensity matched standard-risk control group. Conclusions: Our study confirms that t(11;14) multiple myeloma undergoing upfront autologous transplantation had similar outcomes as patients with multiple myeloma with normal cytogenetic and FISH studies. Existence of additional genomic aberrations by CC or FISH was associated with a worse outcome.
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U2 - 10.1158/1078-0432.CCR-19-0706
DO - 10.1158/1078-0432.CCR-19-0706
M3 - Article
C2 - 31481508
AN - SCOPUS:85075092449
SN - 1078-0432
VL - 25
SP - 6781
EP - 6787
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 22
ER -