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
Language English Country Great Britain, England Media print-electronic
Document type Journal Article
Grant support
UK NIHR Imperial college
PubMed
33580608
DOI
10.1111/ejh.13602
Knihovny.cz E-resources
- Keywords
- autologous transplantation, induction regimen, kinetics of response, multiple myeloma,
- MeSH
- Transplantation, Autologous MeSH
- Time Factors MeSH
- Remission Induction MeSH
- Humans MeSH
- Multiple Myeloma diagnosis mortality therapy MeSH
- Prognosis MeSH
- Antineoplastic Combined Chemotherapy Protocols adverse effects therapeutic use MeSH
- Hematopoietic Stem Cell Transplantation * adverse effects methods MeSH
- Duration of Therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
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
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
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
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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