Maintenance therapy after second autologous hematopoietic cell transplantation for multiple myeloma. A CIBMTR analysis.

Autor: Pasvolsky O; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikvah, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Yeshurun M; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikvah, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Fraser R; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA., Estrada-Merly N; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, 53226, USA., Rozovski U; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikvah, Israel., Shargian-Alon L; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikvah, Israel., Assal A; Department of Medicine, Bone Marrow Transplant and Cell Therapy Program, Columbia University Irving Medical Center, New York, NY, USA., Banerjee R; Division of Hematology-Oncology, University of California San Francisco, San Francisco, CA, USA., Bumma N; Ohio State Medical Center, James Cancer Center, Columbus, OH, USA., Gale RP; Department of Immunology and Inflammation, Haematology Research Centre, Imperial College London, London, UK., Hagen P; Loyola University Medical Center, Maywood, IL, USA., Holmberg L; Fred Hutchinson Cancer Research Center, Seattle, WA, USA., Hossain NM; Department of Medicine, Division of Hematology/Oncology, Stem Cell Transplant Program-Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA., Lazarus HM; University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA., Lee C; Royal Adelaide Hospital, Adelaide, SA, Australia., Mian H; McMaster University, Hamilton, ON, Canada., Miller KC; Massachusetts General Hospital, Boston, MA, USA., Nathan S; Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA., Nagler A; Hematology Division and BMT, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.; Tel Aviv University, Tel Aviv, Israel., Nishihori T; Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center and Research Institute, Tampa, FL, USA., Parrondo RD; Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonsville, FL, USA., Patel S; Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Schroeder MA; Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Usmani SZ; Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA., Wang T; Division of Transplantation and Cellular Therapy, University of Miami, Miami, FL, USA., Wirk B; Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA, USA., Kumar S; Mayo Clinic, Rochester, MN, USA., Shah N; Division of Hematology-Oncology, University of California San Francisco, San Francisco, CA, USA., Qazilbash MH; M.D. Anderson Cancer Center, Houston, TX, USA., D'Souza A; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, 53226, USA. anitadsouza@mcw.edu.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2022 Jan; Vol. 57 (1), pp. 31-37. Date of Electronic Publication: 2021 Oct 04.
DOI: 10.1038/s41409-021-01455-y
Abstrakt: 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.
(© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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