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- Title
Predictors and Impact of Timing of Disease Progression Following Primary Therapy in Multiple Myeloma.
- Authors
Goldman-Mazur, Sarah; Visram, Alissa; Rajkumar, S. Vincent; Kapoor, Prashant; Dispenzieri, Angela; Lacy, Martha Q.; Gertz, Morie A.; Buadi, Francis K.; Hayman, Suzanne R.; Dingli, David; Kourelis, Taxiarchis; Gonsalves, Wilson; Warsame, Rahma; Muchtar, Eli; Leung, Nelson; Kyle, Robert A.; Kumar, Shaji K.
- Abstract
We aimed find prognostic parameters for both long and short survival in myeloma patients based on a large cohort (n = 1557) divided into following subgroups: short ( <2 years), median (2-5 years) and long (>5 years) progression-free survival. This study shows that the duration of the relapse-free significantly influences survival, regardless of high risk cytogenetic features. The information on relapse-free period should be an important parameter in stratifying patients at relapse. In multiple myeloma (MM) significant variation in progression-free survival (PFS) and overall survival (OS) is observed. We examined the outcomes of 1557 MM patients stratified into short (<2 years), medium (between 2 and 5 years) and long (>5 years) PFS. Short PFS occurred in 758 patients (48.7%), medium in 561 patients (36.2%), and long in 238 patients (15.3%). Median post-progression PFS was 9.2 months (95% CI: 8.1-11.0) in the short PFS and 33.1 months (95% CI: 29.0-42.1; P < .001) in the long PFS group. Median post-progression OS was 26.6 months (95% CI: 23.9-29.8) in the short PFS and 87.8 months (95% CI: 71.3- NR; P < .001) in the long PFS. Worse survival in the short PFS was irrespective of high risk (HR) fluorescence in situ hybridization (FISH) features, defined as deletion 17p and/or translocation t(4;14), t(14;16), t(14;20). In a multivariable analysis short PFS was associated with HR FISH, extramedullary plasmacytoma, plasma cell labeling index >2% at diagnosis, nonimmunoglobulin G isotype, treatment without autologous stem cell transplantation and achieving less than very good partial remission. In conclusion, the duration of the PFS significantly influences survival, regardless of HR cytogenetic features. Therefore, it should be considered an important parameter for risk stratification in patients experiencing a relapse.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2024, Vol 24, Issue 3, pe104
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/j.clml.2023.11.008