Autologous stem cell transplantation (ASCT) outcome for multiple myeloma in a tertiary referral centre in Malaysia.

Autor:	Liam CCK; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Boo YL; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Lee YL; Centre for Clinical Trial, Ampang Hospital, Selangor, Malaysia., Law KB; Centre for Clinical Trial, Ampang Hospital, Selangor, Malaysia., Ho KW; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Shahnaz SAKS; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Tan JTC; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Lau NS; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Ong TC; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Tan SM; Department of Haematology, Ampang Hospital, Selangor, Malaysia., Sathar J; Department of Haematology, Ampang Hospital, Selangor, Malaysia.
Jazyk:	angličtina
Zdroj:	Blood cell therapy [Blood Cell Ther] 2020 Dec 04; Vol. 4 (1), pp. 1-8. Date of Electronic Publication: 2020 Dec 04 (Print Publication: 2021).
DOI:	10.31547/bct-2020-009
Abstrakt:	Background: Multiple Myeloma (MM) is characterized by the presence of clonal plasma cells. These often result in complications including bone destruction, hypercalcemia, renal insufficiency, and anaemia. Induction with a triplet or quadruplet regimen followed by autologous stem cell transplantation (ASCT) has been the standard of care for transplant eligible patients to achieve durable remission. Purpose: This is a retrospective analytical study to determine the outcome of Multiple Myeloma patients who underwent ASCT in Ampang Hospital. Materials and Methods: We included a 5-year cohort of patients transplanted from 1st July 2014 to 30th June 2019. Data were obtained through electronic medical records. Prognostic factors for progression-free survival (PFS) and overall survival (OS) were analyzed using simple and multiple Cox proportional hazard regression analysis. All analyses were done using software R version 3.6.2 with validated statistical packages. Results: 139 patients were analyzed. The median age at transplant was 56 years old and 56.1% are males (n＝78). The most common subtype is IgG Kappa (n＝67, 48.2%). Only 93 patients in which the International Staging System (ISS) could be determined, and among them, 33.3% of patients (n＝31) have advanced stage Ⅲ disease. The most common induction received before ASCT was a bortezomib based regimen and/or an immunomodulatory (IMiD) based regimen. 63.3% of patients achieved at least a very good partial response (VGPR) before ASCT. Most patients received myeloablative conditioning (MAC) (n＝119, 85.6%). The mean cell dose is 3.68×10 6 /kg. The median time to engraftment was 11 days for both platelet and absolute neutrophil count (ANC). With the median follow-up of 17.3 (range, 6.2-33.4) months, the median OS and PFS were not reached. The 1-year and 2-year PFS were 75% (95% CI 66-82%) and 52% (95% CI 42-62%), respectively. The 1-year and 2-year OS were 82% (95% CI 74-88%) and 70% (95% CI 60-78%), respectively. 6 patients (4.3%) had transplant-related mortality (TRM). IgA subtype was found to adversely affect PFS. Maintenance therapy and the absence of renal impairment was associated with better PFS and OS. Discussion and Conclusions: Our study found that ASCT following induction treatment is safe and beneficial to achieve a deeper remission status. In our study, the addition of maintenance therapy is associated with an improved outcome in PFS and OS. Competing Interests: The authors declare no conflict of interest. Disclosure forms provided by the authors are available here. (Copyright Ⓒ2021 APBMT. All Rights Reserved.)
Databáze:	MEDLINE
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