The impact of induction regimen on transplant outcome in newly diagnosed multiple myeloma in the era of novel agents

R. Chakraborty, E. Muchtar, Shaji K Kumar, F. K. Buadi, David M Dingli, Angela Dispenzieri, S. R. Hayman, William Hogan, Prashant Kapoor, Martha Lacy, N. Leung, Morie Gertz

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

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.

Original languageEnglish (US)
JournalBone Marrow Transplantation
DOIs
StateAccepted/In press - Aug 22 2016

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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