Impact of Cytogenetic Abnormalities, Induction and Maintenance Regimens on Outcomes After High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Patients With Newly Diagnosed Multiple Myeloma: A Decade-Long Real-World Experience.

Autor:	Thurlapati A; Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC 29425, USA.; These authors contributed equally to the creation of the manuscript., Wesson W; University of Kansas School of Medicine, Kansas City, KS 66103, USA.; These authors contributed equally to the creation of the manuscript., Davis JA; Medical University of South Carolina College of Pharmacy, Charleston, SC 29425, USA., Gaffney KJ; Medical University of South Carolina College of Pharmacy, Charleston, SC 29425, USA., Weeda E; Medical University of South Carolina College of Pharmacy, Charleston, SC 29425, USA., Velayati A; Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC 29425, USA., Bakos JK; Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC 29425, USA., Granger K; Medical University of South Carolina College of Pharmacy, Charleston, SC 29425, USA., Smith D; Medical University of South Carolina College of Pharmacy, Charleston, SC 29425, USA., Maldonado AP; Medical University of South Carolina College of Pharmacy, Charleston, SC 29425, USA., Herrington T; Medical University of South Carolina College of Pharmacy, Charleston, SC 29425, USA., Potts J; Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC 29425, USA., Hashmi H; Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC 29425, USA.
Jazyk:	angličtina
Zdroj:	Journal of hematology [J Hematol] 2023 Dec; Vol. 12 (6), pp. 243-254. Date of Electronic Publication: 2023 Dec 09.
DOI:	10.14740/jh1201
Abstrakt:	Background: High-dose chemotherapy and autologous stem cell transplant (HDT-ASCT) has become a standard of care for transplant eligible newly diagnosed multiple myeloma (NDMM) patients. While cytogenetic abnormalities have been shown to affect outcomes after HDT-ASCT in clinical trials, these trials often exclude or underrepresent elderly patients with comorbidities and those belonging to ethnic minorities. We describe our institutional experience highlighting the impact of high-risk cytogenetic abnormalities (HRCAs) on outcomes after HDT-ASCT for NDMM patients. Methods: A total of 449 patients with NDMM who underwent HDT-ASCT between February 2012 and August 2022 were included in this retrospective analysis. HRCAs included the presence of one or more of: deletion 17p, t(14;16), t(4;14), and amplification 1q. Survival analyses, including progression-free survival (PFS) and overall survival (OS), were performed using Kaplan-Meier estimator. Results: With a median follow-up of 29 (1 - 128) months for the entire patient population, the best overall response rate for the patients with HRCAs was lower compared to those with standard risk cytogenetics (90% vs. 96%; P = 0.01). Patients with HRCAs had an inferior PFS compared to patients with standard-risk cytogenetics (29 vs. 58 months; P < 0.001) without a difference in OS (70 months vs. not reached; P = 0.13). Conclusions: In a multivariable analysis adjusting for factors including age, race, and comorbidities, HRCAs, non-lenalidomide-based maintenance, non-proteasome inhibitor-based maintenance, and age greater than 65 were associated with inferior PFS. Amongst these factors, only non-lenalidomide-based maintenance was associated with inferior OS. Competing Interests: Hamza Hashmi is on advisory boards of Sanofi, BMS, and Janssen. No other authors have any conflict of interests to disclose. (Copyright 2023, Thurlapati et al.)
Databáze:	MEDLINE
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