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.

Ankara University Faculty of Medicine Ankara Turkey

C R O IRCCS Aviano Aviano Italy

Centre for Haematology Imperial College London UK

Chaim Sheba Medical Center Tel Hashomer Israel

Charles University Hospital Prague Czech Republic

CHU Nantes Nantes France

Cliniques Universitaires St Luc Brussels Belgium

Dél pesti Centrumkórház Országos Hematológiai és Infektológiai Intézet Budapest Hungary

Department of Biology Tor Vergata University Rome

Department of Haematology Trinity College Dublin St James's Hospital Dublin 8 Ireland

EBMT Data Office Leiden Netherlands

Fundeni Clinical Institute Bucarest Romania

Hope Directorate St James's Hospital Dublin Ireland

Hospital Universitario Central de Asturias Oviedo Spain

Hucknall Road Nothinghall UK

ICO Hospital Duran 1 Reynals Barcelona Spain

Institut Paoli Calmettes Marseilles France

Medical Department 5 University Hospital Heidelberg Heidelberg Germany

Skanes University Hospital Lund Sweden

Sorbonne Université INSERM UMR_S 938 Centre de Recherche Saint Antoine Team Proliferation and Differentiation of Stem Cells Assistance Publique Hôpitaux de Paris Hôpital Pitié Salpêtrière Service d'Hématologie Paris France

The Medical University of Warsaw Warsaw Poland

Umea University Hospital Umea Sweden

University Hospital Brno Brno Czech Republic

University Hospital of Lille Inserm CHU Lille INSERM Infinite Lille France

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