TY - JOUR
T1 - The impact of induction regimen on transplant outcome in newly diagnosed multiple myeloma in the era of novel agents
AU - Chakraborty, R.
AU - Muchtar, E.
AU - Kumar, Shaji K
AU - Buadi, F. K.
AU - Dingli, David M
AU - Dispenzieri, Angela
AU - Hayman, S. R.
AU - Hogan, William
AU - Kapoor, Prashant
AU - Lacy, Martha
AU - Leung, N.
AU - Gertz, Morie
PY - 2016/8/22
Y1 - 2016/8/22
N2 - We compared overall survival (OS) of 1017 patients with newly diagnosed multiple myeloma (MM) who were treated with different novel agent-based induction regimens and who underwent early autologous stem cell transplant (ASCT). Subgroups were defined by type of induction therapy: cyclophosphamide–bortezomib–dexamethasone (CyBorD; n=193), bortezomib–dexamethasone (Vd; n=64), lenalidomide–dexamethasone (Rd; n=251), bortezomib–lenalidomide–dexamethasone (VRd; n=126), thalidomide–dexamethasone (Td; n=155) and vincristine–doxorubicin–dexamethasone or dexamethasone alone (VAD/Dex; n=228). The median follow-up of the surviving patients was 66.7 months. The 5-year OS rates with CyBorD, Vd, Rd, VRd, Td and VAD/Dex were 79.2%, 72.3%, 79.2%, 79.0%, 57.4% and 63.4%, respectively (log-rank, P<0.001). In a multivariate analysis, after controlling for important patient and disease variables, VRd had a superior OS compared with CyBorD (hazard ratio (HR), 0.32; 95% confidence interval (CI), 0.10–0.88; P=0.03) and Vd (HR, 0.16; 95% CI, 0.04–0.52; P=0.002). In conclusion, our study demonstrates that among patients completing induction therapy and continuing to early transplant, VRd induction leads to improved OS compared with CyBorD and Vd regimens.Bone Marrow Transplantation advance online publication, 22 August 2016; doi:10.1038/bmt.2016.214.
AB - We compared overall survival (OS) of 1017 patients with newly diagnosed multiple myeloma (MM) who were treated with different novel agent-based induction regimens and who underwent early autologous stem cell transplant (ASCT). Subgroups were defined by type of induction therapy: cyclophosphamide–bortezomib–dexamethasone (CyBorD; n=193), bortezomib–dexamethasone (Vd; n=64), lenalidomide–dexamethasone (Rd; n=251), bortezomib–lenalidomide–dexamethasone (VRd; n=126), thalidomide–dexamethasone (Td; n=155) and vincristine–doxorubicin–dexamethasone or dexamethasone alone (VAD/Dex; n=228). The median follow-up of the surviving patients was 66.7 months. The 5-year OS rates with CyBorD, Vd, Rd, VRd, Td and VAD/Dex were 79.2%, 72.3%, 79.2%, 79.0%, 57.4% and 63.4%, respectively (log-rank, P<0.001). In a multivariate analysis, after controlling for important patient and disease variables, VRd had a superior OS compared with CyBorD (hazard ratio (HR), 0.32; 95% confidence interval (CI), 0.10–0.88; P=0.03) and Vd (HR, 0.16; 95% CI, 0.04–0.52; P=0.002). In conclusion, our study demonstrates that among patients completing induction therapy and continuing to early transplant, VRd induction leads to improved OS compared with CyBorD and Vd regimens.Bone Marrow Transplantation advance online publication, 22 August 2016; doi:10.1038/bmt.2016.214.
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U2 - 10.1038/bmt.2016.214
DO - 10.1038/bmt.2016.214
M3 - Article
C2 - 27548464
AN - SCOPUS:84983504724
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
ER -