Some patients with multiple myeloma (MM) with a suboptimal response to induction therapy may have inferior overall survival (OS) after autologous stem cell transplantation (ASCT) compared with patients with a partial response (PR) to induction regimens, according to a retrospective analysis published in Transplantation and Cellular Therapy.
Outcomes after ASCT among patients who have a suboptimal response — defined as stable disease (SD) or progressive disease (PD) — were not previously well-established, making it unclear whether patients in this category should receive transplantation. For this multicenter retrospective study, researchers evaluated outcomes, as compared with patients with a PR after induction therapy, among patients with MM with a suboptimal response who received ASCT.
Overall, data from 3898 patients were included, although the researchers excluded patients with any response better than a PR after induction from their analysis. This left 1463 patients with a PR, 118 patients with SD, and 66 patients with PD. The median age was 60 years (range, 30-77), 38% of patients received reinduction therapy, and 37.7% of patients had high-risk cytogenetics.
The median follow-up was 31.7 months. After this point, analysis showed that the 30-month OS rates in the PR, SD, and PD subgroups were 86.3%, 78.5%, and 39.4%, respectively (P <.001).
Compared with patients with a PR, patients in the SD group with high-risk cytogenetics had significantly inferior OS (P <.001); this was also true among patients treated with reinduction therapy (P =.013).
Further analysis demonstrated that early PD within 12 months after ASCT was linked with inferior OS. Patients without early PD after ASCT did not have inferior OS compared with the SD and PR groups.
“To further improve our understanding, we will continue to investigate the comparison between patients with optimal response and [suboptimal response] and the clinical significance of reinduction therapy,” the authors wrote in their report.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.
Suzuki K, Shimazu Y, Minakata D, et al. Efficacy of autologous stem cell transplantation for patients with myeloma having suboptimal response: A multicenter retrospective analysis. Transplant Cell Ther. Published online August 11, 2023. doi:10.1016/j.jtct.2023.08.006