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- Title
Early Relapse After Autologous Transplant Is Associated With Very Poor Survival and Identifies an Ultra-High-Risk Group of Patients With Myeloma.
- Authors
Kastritis, Efstathios; Roussou, Maria; Eleutherakis-Papaiakovou, Evangelos; Gavriatopoulou, Maria; Migkou, Magdalini; Gika, Dimitra; Fotiou, Despina; Kanellias, Nikolaos; Ziogas, Dimitrios C.; Ntanasis-Stathopoulos, Ioannis; Mparmparousi, Despoina; Gatou, Anastasia; Katopi, Despina; Manios, Efstathios; Liontos, Michail; Giannouli, Stavroula; Tsirigotis, Panagiotis; Terpos, Evangelos; Dimopoulos, Meletios A.
- Abstract
<bold>Introduction: </bold>Patients relapsing early after autologous stem cell transplantation (ASCT) are a particular therapeutic challenge.<bold>Methods: </bold>This was a retrospective, single center study that included 297 consecutive patients that received first-line ASCT RESULTS: We identified 43 (14.5%) patients that relapsed within <12 months. At diagnosis, these patients had more often elevated lactate dehydrogenase, lower estimated glomerular filtration rate, hypercalcemia, and high-risk cytogenetics; the International Staging System stage distribution was similar. Consolidation and maintenance were associated with lower rates of early relapses. Progression-free survival to second-line therapy was 5 months versus 19 months for those with an early versus late relapse (P < .001), the median PFS to second-line therapy was 15.5 months versus >5 years (P < .001) and the median post-ASCT survival was 18 months versus >6 years. The survival after an early relapse has not improved significantly over time. In multivariate analysis, early relapse (hazard ratio, 14; P < .001) was the most important prognostic factor for poor survival after ASCT.<bold>Conclusion: </bold>Patients relapsing <12 months after ASCT comprise an ultra-high-risk group, with poor outcomes even with the application of the more recent combinations, that urgently needs more effective therapies.
- Subjects
MULTIPLE myeloma treatment; GENETICS; RETROSPECTIVE studies; AUTOGRAFTS; MULTIPLE myeloma
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2020, Vol 20, Issue 7, p445
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2019.10.014