Impact of Pretransplant Therapy and Depth of Disease Response before Autologous Transplantation for Multiple Myeloma

Ravi Vij, Shaji K Kumar, Mei Jie Zhang, Xiaobo Zhong, Jiaxing Huang, Angela Dispenzieri, Muneer H. Abidi, Jennifer M. Bird, César O. Freytes, Robert Peter Gale, Tamila L. Kindwall-Keller, Robert A. Kyle, Daniel J. Landsburg, Hillard M. Lazarus, Reinhold Munker, Vivek Roy, Manish Sharma, Dan T. Vogl, Baldeep Wirk, Parameswaran N. Hari

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Patients with multiple myeloma (MM) who are eligible for autologous stem cell transplantation (ASCT) typically receive a finite period of initial therapy before ASCT. It is not clear if patients with suboptimal (less than a partial) response to initial therapy benefit from additional alternative therapy with intent to maximize pretransplant response. We identified 539 patients with MM who had an ASCT after having achieved less than a partial response (PR) to first-line induction chemotherapy between 1995 and 2010. These patients were then divided into 2 groups: those who received additional salvage chemotherapy before ASCT (n=324) and those who had no additional salvage chemotherapy immediately before ASCT (n=215). Additional pretransplant chemotherapy resulted in deepening responses in 68% (complete response in 8% and PR in 60%). On multivariate analysis there was no impact of pretransplant salvage chemotherapy on treatment-related mortality, risk for relapse, progression-free survival, or overall survival. In conclusion, for patients achieving less than a PR to initial induction therapy, including with novel agent combinations, additional pre-ASCT salvage chemotherapy improved the depth of response and pre-ASCT disease status but was not associated with survival benefit.

Original languageEnglish (US)
Pages (from-to)335-341
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2015

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Autologous Transplantation
Stem Cell Transplantation
Multiple Myeloma
Drug Therapy
Therapeutics
Induction Chemotherapy
Survival
Complementary Therapies
Disease-Free Survival
Multivariate Analysis
Recurrence
Mortality

Keywords

  • Autologous transplant
  • Myeloma
  • Primary refractory

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Impact of Pretransplant Therapy and Depth of Disease Response before Autologous Transplantation for Multiple Myeloma. / Vij, Ravi; Kumar, Shaji K; Zhang, Mei Jie; Zhong, Xiaobo; Huang, Jiaxing; Dispenzieri, Angela; Abidi, Muneer H.; Bird, Jennifer M.; Freytes, César O.; Gale, Robert Peter; Kindwall-Keller, Tamila L.; Kyle, Robert A.; Landsburg, Daniel J.; Lazarus, Hillard M.; Munker, Reinhold; Roy, Vivek; Sharma, Manish; Vogl, Dan T.; Wirk, Baldeep; Hari, Parameswaran N.

In: Biology of Blood and Marrow Transplantation, Vol. 21, No. 2, 01.02.2015, p. 335-341.

Research output: Contribution to journalArticle

Vij, R, Kumar, SK, Zhang, MJ, Zhong, X, Huang, J, Dispenzieri, A, Abidi, MH, Bird, JM, Freytes, CO, Gale, RP, Kindwall-Keller, TL, Kyle, RA, Landsburg, DJ, Lazarus, HM, Munker, R, Roy, V, Sharma, M, Vogl, DT, Wirk, B & Hari, PN 2015, 'Impact of Pretransplant Therapy and Depth of Disease Response before Autologous Transplantation for Multiple Myeloma', Biology of Blood and Marrow Transplantation, vol. 21, no. 2, pp. 335-341. https://doi.org/10.1016/j.bbmt.2014.10.023
Vij, Ravi ; Kumar, Shaji K ; Zhang, Mei Jie ; Zhong, Xiaobo ; Huang, Jiaxing ; Dispenzieri, Angela ; Abidi, Muneer H. ; Bird, Jennifer M. ; Freytes, César O. ; Gale, Robert Peter ; Kindwall-Keller, Tamila L. ; Kyle, Robert A. ; Landsburg, Daniel J. ; Lazarus, Hillard M. ; Munker, Reinhold ; Roy, Vivek ; Sharma, Manish ; Vogl, Dan T. ; Wirk, Baldeep ; Hari, Parameswaran N. / Impact of Pretransplant Therapy and Depth of Disease Response before Autologous Transplantation for Multiple Myeloma. In: Biology of Blood and Marrow Transplantation. 2015 ; Vol. 21, No. 2. pp. 335-341.
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