Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG Research Project

Saad Z. Usmani, Antje Hoering, Michele Cavo, Jesus San Miguel, Hartmut Goldschimdt, Roman Hajek, Ingemar Turesson, Juan Jose Lahuerta, Michel Attal, Bart Barlogie, Jae Hoon Lee, Shaji K Kumar, Stig Lenhoff, Gareth Morgan, S Vincent Rajkumar, Brian G.M. Durie, Philippe Moreau

Research output: Contribution to journalArticle

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Abstract

PURPOSE: multiple myeloma is considered an incurable hematologic cancer but a subset of patients can achieve long-term remissions and survival. The present study examines the clinical features of long-term survival as it correlates to depth of disease response. PATIENTS & METHODS: this was a multi-institutional, international, retrospective analysis of high-dose melphalan-autologous stem cell transplant (HDM-ASCT) eligible MM patients included in clinical trials. Clinical variable and survival data were collected from 7291 MM patients from Czech Republic, France, Germany, Italy, Korea, Spain, the Nordic Myeloma Study Group and the United States. Kaplan-Meier curves were used to assess progression-free survival (PFS) and overall survival (OS). Relative survival (RS) and statistical cure fractions (CF) were computed for all patients with available data. RESULTS: achieving CR at 1 year was associated with superior PFS (median PFS 3.3 years vs. 2.6 years, p < 0.0001) as well as OS (median OS 8.5 years vs. 6.3 years, p < 0.0001). Clinical variables at diagnosis associated with 5-year survival and 10-year survival were compared with those associated with 2-year death. In multivariate analysis, age over 65 years (OR 1.87, p = 0.002), IgA Isotype (OR 1.53, p = 0.004), low albumin < 3.5 g/dL (OR = 1.36, p = 0.023), elevated beta 2 microglobulin ≥ 3.5 mg/dL (OR 1.86, p < 0.001), serum creatinine levels ≥ 2 mg/dL (OR 1.77, p = 0.005), hemoglobin levels < 10 g/dL (OR 1.55, p = 0.003), and platelet count < 150k/μL (OR 2.26, p < 0.001) appeared to be negatively associated with 10-year survival. The relative survival for the cohort was ~0.9, and the statistical cure fraction was 14.3%. CONCLUSIONS: these data identify CR as an important predictor of long-term survival for HDM-ASCT eligible MM patients. They also identify clinical variables reflective of higher disease burden as poor prognostic markers for long-term survival.

Original languageEnglish (US)
Number of pages1
JournalBlood Cancer Journal
Volume8
Issue number12
DOIs
StatePublished - Nov 23 2018

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Multiple Myeloma
Transplants
Survival
Research
Disease-Free Survival
Melphalan
Stem Cells
Czech Republic
Korea
Platelet Count
Spain
Immunoglobulin A
Italy
France
Germany
Albumins
Creatinine
Hemoglobins
Multivariate Analysis
Clinical Trials

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG Research Project. / Usmani, Saad Z.; Hoering, Antje; Cavo, Michele; Miguel, Jesus San; Goldschimdt, Hartmut; Hajek, Roman; Turesson, Ingemar; Lahuerta, Juan Jose; Attal, Michel; Barlogie, Bart; Lee, Jae Hoon; Kumar, Shaji K; Lenhoff, Stig; Morgan, Gareth; Rajkumar, S Vincent; Durie, Brian G.M.; Moreau, Philippe.

In: Blood Cancer Journal, Vol. 8, No. 12, 23.11.2018.

Research output: Contribution to journalArticle

Usmani, SZ, Hoering, A, Cavo, M, Miguel, JS, Goldschimdt, H, Hajek, R, Turesson, I, Lahuerta, JJ, Attal, M, Barlogie, B, Lee, JH, Kumar, SK, Lenhoff, S, Morgan, G, Rajkumar, SV, Durie, BGM & Moreau, P 2018, 'Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG Research Project', Blood Cancer Journal, vol. 8, no. 12. https://doi.org/10.1038/s41408-018-0155-7
Usmani, Saad Z. ; Hoering, Antje ; Cavo, Michele ; Miguel, Jesus San ; Goldschimdt, Hartmut ; Hajek, Roman ; Turesson, Ingemar ; Lahuerta, Juan Jose ; Attal, Michel ; Barlogie, Bart ; Lee, Jae Hoon ; Kumar, Shaji K ; Lenhoff, Stig ; Morgan, Gareth ; Rajkumar, S Vincent ; Durie, Brian G.M. ; Moreau, Philippe. / Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG Research Project. In: Blood Cancer Journal. 2018 ; Vol. 8, No. 12.
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abstract = "PURPOSE: multiple myeloma is considered an incurable hematologic cancer but a subset of patients can achieve long-term remissions and survival. The present study examines the clinical features of long-term survival as it correlates to depth of disease response. PATIENTS & METHODS: this was a multi-institutional, international, retrospective analysis of high-dose melphalan-autologous stem cell transplant (HDM-ASCT) eligible MM patients included in clinical trials. Clinical variable and survival data were collected from 7291 MM patients from Czech Republic, France, Germany, Italy, Korea, Spain, the Nordic Myeloma Study Group and the United States. Kaplan-Meier curves were used to assess progression-free survival (PFS) and overall survival (OS). Relative survival (RS) and statistical cure fractions (CF) were computed for all patients with available data. RESULTS: achieving CR at 1 year was associated with superior PFS (median PFS 3.3 years vs. 2.6 years, p < 0.0001) as well as OS (median OS 8.5 years vs. 6.3 years, p < 0.0001). Clinical variables at diagnosis associated with 5-year survival and 10-year survival were compared with those associated with 2-year death. In multivariate analysis, age over 65 years (OR 1.87, p = 0.002), IgA Isotype (OR 1.53, p = 0.004), low albumin < 3.5 g/dL (OR = 1.36, p = 0.023), elevated beta 2 microglobulin ≥ 3.5 mg/dL (OR 1.86, p < 0.001), serum creatinine levels ≥ 2 mg/dL (OR 1.77, p = 0.005), hemoglobin levels < 10 g/dL (OR 1.55, p = 0.003), and platelet count < 150k/μL (OR 2.26, p < 0.001) appeared to be negatively associated with 10-year survival. The relative survival for the cohort was ~0.9, and the statistical cure fraction was 14.3{\%}. CONCLUSIONS: these data identify CR as an important predictor of long-term survival for HDM-ASCT eligible MM patients. They also identify clinical variables reflective of higher disease burden as poor prognostic markers for long-term survival.",
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T1 - Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG Research Project

AU - Usmani, Saad Z.

AU - Hoering, Antje

AU - Cavo, Michele

AU - Miguel, Jesus San

AU - Goldschimdt, Hartmut

AU - Hajek, Roman

AU - Turesson, Ingemar

AU - Lahuerta, Juan Jose

AU - Attal, Michel

AU - Barlogie, Bart

AU - Lee, Jae Hoon

AU - Kumar, Shaji K

AU - Lenhoff, Stig

AU - Morgan, Gareth

AU - Rajkumar, S Vincent

AU - Durie, Brian G.M.

AU - Moreau, Philippe

PY - 2018/11/23

Y1 - 2018/11/23

N2 - PURPOSE: multiple myeloma is considered an incurable hematologic cancer but a subset of patients can achieve long-term remissions and survival. The present study examines the clinical features of long-term survival as it correlates to depth of disease response. PATIENTS & METHODS: this was a multi-institutional, international, retrospective analysis of high-dose melphalan-autologous stem cell transplant (HDM-ASCT) eligible MM patients included in clinical trials. Clinical variable and survival data were collected from 7291 MM patients from Czech Republic, France, Germany, Italy, Korea, Spain, the Nordic Myeloma Study Group and the United States. Kaplan-Meier curves were used to assess progression-free survival (PFS) and overall survival (OS). Relative survival (RS) and statistical cure fractions (CF) were computed for all patients with available data. RESULTS: achieving CR at 1 year was associated with superior PFS (median PFS 3.3 years vs. 2.6 years, p < 0.0001) as well as OS (median OS 8.5 years vs. 6.3 years, p < 0.0001). Clinical variables at diagnosis associated with 5-year survival and 10-year survival were compared with those associated with 2-year death. In multivariate analysis, age over 65 years (OR 1.87, p = 0.002), IgA Isotype (OR 1.53, p = 0.004), low albumin < 3.5 g/dL (OR = 1.36, p = 0.023), elevated beta 2 microglobulin ≥ 3.5 mg/dL (OR 1.86, p < 0.001), serum creatinine levels ≥ 2 mg/dL (OR 1.77, p = 0.005), hemoglobin levels < 10 g/dL (OR 1.55, p = 0.003), and platelet count < 150k/μL (OR 2.26, p < 0.001) appeared to be negatively associated with 10-year survival. The relative survival for the cohort was ~0.9, and the statistical cure fraction was 14.3%. CONCLUSIONS: these data identify CR as an important predictor of long-term survival for HDM-ASCT eligible MM patients. They also identify clinical variables reflective of higher disease burden as poor prognostic markers for long-term survival.

AB - PURPOSE: multiple myeloma is considered an incurable hematologic cancer but a subset of patients can achieve long-term remissions and survival. The present study examines the clinical features of long-term survival as it correlates to depth of disease response. PATIENTS & METHODS: this was a multi-institutional, international, retrospective analysis of high-dose melphalan-autologous stem cell transplant (HDM-ASCT) eligible MM patients included in clinical trials. Clinical variable and survival data were collected from 7291 MM patients from Czech Republic, France, Germany, Italy, Korea, Spain, the Nordic Myeloma Study Group and the United States. Kaplan-Meier curves were used to assess progression-free survival (PFS) and overall survival (OS). Relative survival (RS) and statistical cure fractions (CF) were computed for all patients with available data. RESULTS: achieving CR at 1 year was associated with superior PFS (median PFS 3.3 years vs. 2.6 years, p < 0.0001) as well as OS (median OS 8.5 years vs. 6.3 years, p < 0.0001). Clinical variables at diagnosis associated with 5-year survival and 10-year survival were compared with those associated with 2-year death. In multivariate analysis, age over 65 years (OR 1.87, p = 0.002), IgA Isotype (OR 1.53, p = 0.004), low albumin < 3.5 g/dL (OR = 1.36, p = 0.023), elevated beta 2 microglobulin ≥ 3.5 mg/dL (OR 1.86, p < 0.001), serum creatinine levels ≥ 2 mg/dL (OR 1.77, p = 0.005), hemoglobin levels < 10 g/dL (OR 1.55, p = 0.003), and platelet count < 150k/μL (OR 2.26, p < 0.001) appeared to be negatively associated with 10-year survival. The relative survival for the cohort was ~0.9, and the statistical cure fraction was 14.3%. CONCLUSIONS: these data identify CR as an important predictor of long-term survival for HDM-ASCT eligible MM patients. They also identify clinical variables reflective of higher disease burden as poor prognostic markers for long-term survival.

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