Background In autologous stem cell transplant (ASCT)-eligible myeloma patients, prolonged induction does not necessarily improve the depth of response.Method We analyzed 1222 ASCT patients who were classified based on (a) the interval between induction and stem cell collection, (b) the type of induction regimen: BID (Bortezomib, IMiDs, and Dexamethasone), Bortezomib-based, or CTD (Cyclophosphamide, Thalidomide, and Dexamethasone), and (c) the time to best response (Early ie, best response within 4 or 5 months, depending on the regimen vs Late; Good ie, VGPR or better vs Poor).Results The length of induction treatment required to achieve a Good response did not affect PFS (P = .65) or OS (P = .61) post-ASCT. The three types of regimen resulted in similar outcomes: median PFS 31, 27.7 and 30.8 months (P = .31), and median OS 81.7, 92.7, and 77.4 months, respectively (P = .83). On multivariate analysis, neither the type nor the duration of the induction regimen affected OS and PFS, except for Early Good Responders who had a better PFS compared to Early Poor Responders (HR = 1.21, P-value = .02). However, achieving a Good response at induction was associated with a better response (>= VGPR) post-transplant.Conclusion The kinetics of response did not affect outcomes.

Garderet, L., Sbianchi, G., Iacobelli, S., Blaise, D., Byrne, J., Remenyi, P., et al. (2021). Prognostic impact of early-versus-late responses to different induction regimens in patients with myeloma undergoing autologous hematopoietic cell transplantation: Results from the CALM study by the CMWP of the EBMT. EUROPEAN JOURNAL OF HAEMATOLOGY, 106(5), 708-715 [10.1111/ejh.13602].

Prognostic impact of early-versus-late responses to different induction regimens in patients with myeloma undergoing autologous hematopoietic cell transplantation: Results from the CALM study by the CMWP of the EBMT

Sbianchi, G;Iacobelli, S;Tanase, A;
2021-01-01

Abstract

Background In autologous stem cell transplant (ASCT)-eligible myeloma patients, prolonged induction does not necessarily improve the depth of response.Method We analyzed 1222 ASCT patients who were classified based on (a) the interval between induction and stem cell collection, (b) the type of induction regimen: BID (Bortezomib, IMiDs, and Dexamethasone), Bortezomib-based, or CTD (Cyclophosphamide, Thalidomide, and Dexamethasone), and (c) the time to best response (Early ie, best response within 4 or 5 months, depending on the regimen vs Late; Good ie, VGPR or better vs Poor).Results The length of induction treatment required to achieve a Good response did not affect PFS (P = .65) or OS (P = .61) post-ASCT. The three types of regimen resulted in similar outcomes: median PFS 31, 27.7 and 30.8 months (P = .31), and median OS 81.7, 92.7, and 77.4 months, respectively (P = .83). On multivariate analysis, neither the type nor the duration of the induction regimen affected OS and PFS, except for Early Good Responders who had a better PFS compared to Early Poor Responders (HR = 1.21, P-value = .02). However, achieving a Good response at induction was associated with a better response (>= VGPR) post-transplant.Conclusion The kinetics of response did not affect outcomes.
2021
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/01 - STATISTICA MEDICA
English
autologous transplantation; induction regimen; kinetics of response; multiple myeloma; Antineoplastic Combined Chemotherapy Protocols; Duration of Therapy; Humans; Multiple Myeloma; Prognosis; Remission Induction; Time Factors; Transplantation, Autologous; Treatment Outcome; Hematopoietic Stem Cell Transplantation
Garderet, L., Sbianchi, G., Iacobelli, S., Blaise, D., Byrne, J., Remenyi, P., et al. (2021). Prognostic impact of early-versus-late responses to different induction regimens in patients with myeloma undergoing autologous hematopoietic cell transplantation: Results from the CALM study by the CMWP of the EBMT. EUROPEAN JOURNAL OF HAEMATOLOGY, 106(5), 708-715 [10.1111/ejh.13602].
Garderet, L; Sbianchi, G; Iacobelli, S; Blaise, D; Byrne, J; Remenyi, P; Apperley, J; Touzeau, C; Isaksson, C; Browne, P; Mayer, J; Lenhoff, S; Muniz,...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/302897
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