Impact of failed response to novel agent induction in autologous stem cell transplantation for multiple myeloma

被引:21
作者
Lee, Sung-Eun [1 ]
Yoon, Jae-Ho [1 ]
Shin, Seung-Hwan [1 ]
Cho, Byung-Sik [1 ]
Eom, Ki-Seong [1 ]
Kim, Yoo-Jin [1 ]
Kim, Hee-Je [1 ]
Lee, Seok [1 ]
Cho, Seok-Goo [1 ]
Kim, Dong-Wook [1 ]
Lee, Jong-Wook [1 ]
Min, Woo-Sung [1 ]
Park, Chong-Won [1 ]
Min, Chang-Ki [1 ]
机构
[1] Catholic Univ Korea, Dept Internal Med, Seoul St Marys Hosp, Coll Med, Seoul 37701, South Korea
关键词
Multiple myeloma; Autologous stem cell transplantation; Novel agents; Induction treatment; THALIDOMIDE PLUS DEXAMETHASONE; NEWLY-DIAGNOSED MYELOMA; THERAPY; BORTEZOMIB; SURVIVAL; TRIAL;
D O I
10.1007/s00277-013-1911-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to evaluate the impact of the response to induction therapy on the long-term prognosis of multiple myeloma (MM) after autologous stem cell transplantation (ASCT) in the era of novel agents (NAs). A total of 171 patients who were newly diagnosed with MM and underwent early ASCT were analyzed. One hundred ten had a NA-based induction therapy, and 61 patients had a non-NA-based induction therapy. After a median follow-up of 45.4 months, the 4-year overall survival (OS) and progression-free survival (PFS) from transplantation were 60.5 and 25.5 %, respectively, for the NA-based induction group and 54.6 and 15.6 %, respectively, for the non-NA-based induction group. Multivariate analyses revealed that the patients who had NA-based induction had a significantly shorter OS (P < 0.001) and PFS (P < 0.001) when at least a partial response (PR) was not achieved. In patients who did not receive NAs before ASCT, lack of at least a PR to induction therapy was not associated with a survival disadvantage. These findings suggest that, unlike pretransplantation induction before NAs, patients who do not respond to induction treatment using NAs may not derive a benefit from ASCT. The relevance of induction failure differs for corticosteroid- and NA-based induction.
引用
收藏
页码:627 / 634
页数:8
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