TY - JOUR
T1 - Maintenance therapy after second autologous hematopoietic cell transplantation for multiple myeloma. A CIBMTR analysis
AU - Pasvolsky, Oren
AU - Yeshurun, Moshe
AU - Fraser, Raphael
AU - Estrada-Merly, Noel
AU - Rozovski, Uri
AU - Shargian-Alon, Liat
AU - Assal, Amer
AU - Banerjee, Rahul
AU - Bumma, Naresh
AU - Gale, Robert Peter
AU - Hagen, Patrick
AU - Holmberg, Leona
AU - Hossain, Nasheed M.
AU - Lazarus, Hillard M.
AU - Lee, Cindy
AU - Mian, Hira
AU - Miller, Kevin C.
AU - Nathan, Sunita
AU - Nagler, Arnon
AU - Nishihori, Taiga
AU - Parrondo, Ricardo D.
AU - Patel, Sagar
AU - Schroeder, Mark A.
AU - Usmani, Saad Z.
AU - Wang, Trent
AU - Wirk, Baldeep
AU - Kumar, Shaji
AU - Shah, Nina
AU - Qazilbash, Muzaffar H.
AU - D’Souza, Anita
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/1
Y1 - 2022/1
N2 - The role of maintenance therapy after high-dose chemotherapy and first autologous transplantation in multiple myeloma (MM) is well established. We explored the effect of maintenance therapy on outcomes after salvage second autologous hematopoietic cell transplant (AHCT2) using the Center for International Blood and Marrow Transplant Research registry. Outcomes of interest included non-relapse mortality (NRM), relapse/progression (REL), progression-free and overall survival (PFS, OS). Of 522 patients who underwent AHCT2 between 2010 and 2018, 342 received maintenance therapy and 180 did not. Maintenance regimens included lenalidomide (42%), pomalidomide (13%), and bortezomib (13%). Median follow up was 58 months in the maintenance group and 61.5 months in the no-maintenance group. Univariate analysis showed superior outcomes at 5 years in maintenance compared to the no-maintenance group: NRM 2 (0.7–3.9)% vs 9.9 (5.9–14.9)%, (p < 0.01), REL 70.2 (64.4–75.8)% vs 80.3 (73.6–86.3)% (p < 0.01), PFS 27.8 (22.4–33.5)% vs. 9.8 (5.5–15.2)% (p < 0.01), and OS 54 (47.5–60.5)% vs 30.9 (23.2–39.2)% (p < 0.01), respectively. Use of maintenance therapy retained its association with improved outcomes in multivariate analysis. There was no difference in second cancers in the two groups (p = 0.39). We conclude that maintenance after AHCT2 is associated with improved 5-year outcomes.
AB - The role of maintenance therapy after high-dose chemotherapy and first autologous transplantation in multiple myeloma (MM) is well established. We explored the effect of maintenance therapy on outcomes after salvage second autologous hematopoietic cell transplant (AHCT2) using the Center for International Blood and Marrow Transplant Research registry. Outcomes of interest included non-relapse mortality (NRM), relapse/progression (REL), progression-free and overall survival (PFS, OS). Of 522 patients who underwent AHCT2 between 2010 and 2018, 342 received maintenance therapy and 180 did not. Maintenance regimens included lenalidomide (42%), pomalidomide (13%), and bortezomib (13%). Median follow up was 58 months in the maintenance group and 61.5 months in the no-maintenance group. Univariate analysis showed superior outcomes at 5 years in maintenance compared to the no-maintenance group: NRM 2 (0.7–3.9)% vs 9.9 (5.9–14.9)%, (p < 0.01), REL 70.2 (64.4–75.8)% vs 80.3 (73.6–86.3)% (p < 0.01), PFS 27.8 (22.4–33.5)% vs. 9.8 (5.5–15.2)% (p < 0.01), and OS 54 (47.5–60.5)% vs 30.9 (23.2–39.2)% (p < 0.01), respectively. Use of maintenance therapy retained its association with improved outcomes in multivariate analysis. There was no difference in second cancers in the two groups (p = 0.39). We conclude that maintenance after AHCT2 is associated with improved 5-year outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85116374147&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85116374147&partnerID=8YFLogxK
U2 - 10.1038/s41409-021-01455-y
DO - 10.1038/s41409-021-01455-y
M3 - Article
C2 - 34608275
AN - SCOPUS:85116374147
SN - 0268-3369
VL - 57
SP - 31
EP - 37
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 1
ER -