Outcome of autologous hematopoietic stem cell transplantation in refractory multiple myeloma

Lauren W. Veltri; Denái R. Milton; Ruby Delgado; Nina Shah; Krina Patel; Yago Nieto; Partow Kebriaei; Uday R. Popat; Simrit Parmar; Betul Oran; Stefan Ciurea; Chitra Hosing; Hans C. Lee; Elisabet Manasanch; Robert Z. Orlowski; Elizabeth J. Shpall; Richard E. Champlin; Muzaffar H. Qazilbash; Qaiser Bashir

doi:10.1002/cncr.30770

Outcome of autologous hematopoietic stem cell transplantation in refractory multiple myeloma

Lauren W. Veltri, Denái R. Milton, Ruby Delgado, Nina Shah, Krina Patel, Yago Nieto, Partow Kebriaei, Uday R. Popat, Simrit Parmar, Betul Oran, Stefan Ciurea, Chitra Hosing, Hans C. Lee, Elisabet Manasanch, Robert Z. Orlowski, Elizabeth J. Shpall, Richard E. Champlin, Muzaffar H. Qazilbash, Qaiser Bashir

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: Despite the introduction of effective, novel agents, the outcome of patients with refractory multiple myeloma remains poor, particularly those who are refractory to both proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs). Limited data are available on the role of autologous hematopoietic stem cell transplantation in this population. METHODS: Patients with refractory myeloma who underwent first autologous hematopoietic stem cell transplantation (auto-HCT) between March 2000 and October 2015 were retrospectively analyzed. Those who had primary refractory disease and those with relapsed and refractory disease were included. Disease that was refractory to at least 1 PI and at least 1 IMiD was classified as double-refractory multiple myeloma (DR-MM). RESULTS: In total, 233 patients were identified, including 105 (45%) classified with DR-MM and 128 (55%) classified with nondouble-refractory myeloma (NDR-MM). At a median follow-up of 42 months for surviving patients, at least a partial response was observed in 188 patients (81%; 83 patients in the DR-MM group [79%] and 105 patients in the NDR-MM [82%]; P =.77). A near complete response or better was observed in 52 patients (22%; 25 patients in the DR-MM group [24%] and 27 patients in the NDR-MM group [21%]; P =.77). The median progression-free survival was 17.6 months (14.4 months in the DR-MM group and 18.2 months in the NDR-MM group), and the 2-year progression-free survival rate was 38% (35% in the DR-MM group and 40% in the NDR-MM group; P =.40). The median overall survival was 48 months (38.9 months in the DR-MM group and 56.6 months in the NDR-MM group), and the 2-year overall survival rate was 74% (71% in the DR-MM group and 76% in the NDR-MM group; P =.27). CONCLUSIONS: The current findings indicate that auto-HCT is an effective and safe therapy in patients with refractory multiple myeloma, including those who are refractory to IMiDs and PIs. Cancer 2017;123:3568-75.

Original language	English (US)
Pages (from-to)	3568-3575
Number of pages	8
Journal	Cancer
Volume	123
Issue number	18
DOIs	https://doi.org/10.1002/cncr.30770
State	Published - Sep 15 2017

Keywords

autologous transplantation
immunomodulatory agent
multiple myeloma
proteasome inhibitor
refractory disease

ASJC Scopus subject areas

Oncology
Cancer Research

MD Anderson CCSG core facilities

Biostatistics Resource Group

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10.1002/cncr.30770

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Veltri, L. W., Milton, D. R., Delgado, R., Shah, N., Patel, K., Nieto, Y., Kebriaei, P., Popat, U. R., Parmar, S., Oran, B., Ciurea, S., Hosing, C., Lee, H. C., Manasanch, E., Orlowski, R. Z., Shpall, E. J., Champlin, R. E., Qazilbash, M. H., & Bashir, Q. (2017). Outcome of autologous hematopoietic stem cell transplantation in refractory multiple myeloma. Cancer, 123(18), 3568-3575. https://doi.org/10.1002/cncr.30770

Veltri, LW, Milton, DR, Delgado, R, Shah, N, Patel, K , Nieto, Y , Kebriaei, P , Popat, UR , Parmar, S , Oran, B, Ciurea, S, Hosing, C , Lee, HC, Manasanch, E, Orlowski, RZ , Shpall, EJ , Champlin, RE , Qazilbash, MH & Bashir, Q 2017, 'Outcome of autologous hematopoietic stem cell transplantation in refractory multiple myeloma', Cancer, vol. 123, no. 18, pp. 3568-3575. https://doi.org/10.1002/cncr.30770

@article{4bd6ab8f2d074670b5217a3bd5c69210,

title = "Outcome of autologous hematopoietic stem cell transplantation in refractory multiple myeloma",

abstract = "BACKGROUND: Despite the introduction of effective, novel agents, the outcome of patients with refractory multiple myeloma remains poor, particularly those who are refractory to both proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs). Limited data are available on the role of autologous hematopoietic stem cell transplantation in this population. METHODS: Patients with refractory myeloma who underwent first autologous hematopoietic stem cell transplantation (auto-HCT) between March 2000 and October 2015 were retrospectively analyzed. Those who had primary refractory disease and those with relapsed and refractory disease were included. Disease that was refractory to at least 1 PI and at least 1 IMiD was classified as double-refractory multiple myeloma (DR-MM). RESULTS: In total, 233 patients were identified, including 105 (45%) classified with DR-MM and 128 (55%) classified with nondouble-refractory myeloma (NDR-MM). At a median follow-up of 42 months for surviving patients, at least a partial response was observed in 188 patients (81%; 83 patients in the DR-MM group [79%] and 105 patients in the NDR-MM [82%]; P =.77). A near complete response or better was observed in 52 patients (22%; 25 patients in the DR-MM group [24%] and 27 patients in the NDR-MM group [21%]; P =.77). The median progression-free survival was 17.6 months (14.4 months in the DR-MM group and 18.2 months in the NDR-MM group), and the 2-year progression-free survival rate was 38% (35% in the DR-MM group and 40% in the NDR-MM group; P =.40). The median overall survival was 48 months (38.9 months in the DR-MM group and 56.6 months in the NDR-MM group), and the 2-year overall survival rate was 74% (71% in the DR-MM group and 76% in the NDR-MM group; P =.27). CONCLUSIONS: The current findings indicate that auto-HCT is an effective and safe therapy in patients with refractory multiple myeloma, including those who are refractory to IMiDs and PIs. Cancer 2017;123:3568-75.",

keywords = "autologous transplantation, immunomodulatory agent, multiple myeloma, proteasome inhibitor, refractory disease",

author = "Veltri, {Lauren W.} and Milton, {Den{\'a}i R.} and Ruby Delgado and Nina Shah and Krina Patel and Yago Nieto and Partow Kebriaei and Popat, {Uday R.} and Simrit Parmar and Betul Oran and Stefan Ciurea and Chitra Hosing and Lee, {Hans C.} and Elisabet Manasanch and Orlowski, {Robert Z.} and Shpall, {Elizabeth J.} and Champlin, {Richard E.} and Qazilbash, {Muzaffar H.} and Qaiser Bashir",

note = "Publisher Copyright: {\textcopyright} 2017 American Cancer Society",

year = "2017",

month = sep,

day = "15",

doi = "10.1002/cncr.30770",

language = "English (US)",

volume = "123",

pages = "3568--3575",

journal = "Cancer",

issn = "0008-543X",

publisher = "John Wiley and Sons Inc.",

number = "18",

}

TY - JOUR

T1 - Outcome of autologous hematopoietic stem cell transplantation in refractory multiple myeloma

AU - Veltri, Lauren W.

AU - Milton, Denái R.

AU - Delgado, Ruby

AU - Shah, Nina

AU - Patel, Krina

AU - Nieto, Yago

AU - Kebriaei, Partow

AU - Popat, Uday R.

AU - Parmar, Simrit

AU - Oran, Betul

AU - Ciurea, Stefan

AU - Hosing, Chitra

AU - Lee, Hans C.

AU - Manasanch, Elisabet

AU - Orlowski, Robert Z.

AU - Shpall, Elizabeth J.

AU - Champlin, Richard E.

AU - Qazilbash, Muzaffar H.

AU - Bashir, Qaiser

PY - 2017/9/15

Y1 - 2017/9/15

N2 - BACKGROUND: Despite the introduction of effective, novel agents, the outcome of patients with refractory multiple myeloma remains poor, particularly those who are refractory to both proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs). Limited data are available on the role of autologous hematopoietic stem cell transplantation in this population. METHODS: Patients with refractory myeloma who underwent first autologous hematopoietic stem cell transplantation (auto-HCT) between March 2000 and October 2015 were retrospectively analyzed. Those who had primary refractory disease and those with relapsed and refractory disease were included. Disease that was refractory to at least 1 PI and at least 1 IMiD was classified as double-refractory multiple myeloma (DR-MM). RESULTS: In total, 233 patients were identified, including 105 (45%) classified with DR-MM and 128 (55%) classified with nondouble-refractory myeloma (NDR-MM). At a median follow-up of 42 months for surviving patients, at least a partial response was observed in 188 patients (81%; 83 patients in the DR-MM group [79%] and 105 patients in the NDR-MM [82%]; P =.77). A near complete response or better was observed in 52 patients (22%; 25 patients in the DR-MM group [24%] and 27 patients in the NDR-MM group [21%]; P =.77). The median progression-free survival was 17.6 months (14.4 months in the DR-MM group and 18.2 months in the NDR-MM group), and the 2-year progression-free survival rate was 38% (35% in the DR-MM group and 40% in the NDR-MM group; P =.40). The median overall survival was 48 months (38.9 months in the DR-MM group and 56.6 months in the NDR-MM group), and the 2-year overall survival rate was 74% (71% in the DR-MM group and 76% in the NDR-MM group; P =.27). CONCLUSIONS: The current findings indicate that auto-HCT is an effective and safe therapy in patients with refractory multiple myeloma, including those who are refractory to IMiDs and PIs. Cancer 2017;123:3568-75.

AB - BACKGROUND: Despite the introduction of effective, novel agents, the outcome of patients with refractory multiple myeloma remains poor, particularly those who are refractory to both proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs). Limited data are available on the role of autologous hematopoietic stem cell transplantation in this population. METHODS: Patients with refractory myeloma who underwent first autologous hematopoietic stem cell transplantation (auto-HCT) between March 2000 and October 2015 were retrospectively analyzed. Those who had primary refractory disease and those with relapsed and refractory disease were included. Disease that was refractory to at least 1 PI and at least 1 IMiD was classified as double-refractory multiple myeloma (DR-MM). RESULTS: In total, 233 patients were identified, including 105 (45%) classified with DR-MM and 128 (55%) classified with nondouble-refractory myeloma (NDR-MM). At a median follow-up of 42 months for surviving patients, at least a partial response was observed in 188 patients (81%; 83 patients in the DR-MM group [79%] and 105 patients in the NDR-MM [82%]; P =.77). A near complete response or better was observed in 52 patients (22%; 25 patients in the DR-MM group [24%] and 27 patients in the NDR-MM group [21%]; P =.77). The median progression-free survival was 17.6 months (14.4 months in the DR-MM group and 18.2 months in the NDR-MM group), and the 2-year progression-free survival rate was 38% (35% in the DR-MM group and 40% in the NDR-MM group; P =.40). The median overall survival was 48 months (38.9 months in the DR-MM group and 56.6 months in the NDR-MM group), and the 2-year overall survival rate was 74% (71% in the DR-MM group and 76% in the NDR-MM group; P =.27). CONCLUSIONS: The current findings indicate that auto-HCT is an effective and safe therapy in patients with refractory multiple myeloma, including those who are refractory to IMiDs and PIs. Cancer 2017;123:3568-75.

KW - autologous transplantation

KW - immunomodulatory agent

KW - multiple myeloma

KW - proteasome inhibitor

KW - refractory disease

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U2 - 10.1002/cncr.30770

DO - 10.1002/cncr.30770

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AN - SCOPUS:85019644158

SN - 0008-543X

VL - 123

SP - 3568

EP - 3575

JO - Cancer

JF - Cancer

IS - 18

ER -

Outcome of autologous hematopoietic stem cell transplantation in refractory multiple myeloma

Abstract

Keywords

ASJC Scopus subject areas

MD Anderson CCSG core facilities

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