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Relapse with plasmacytoma after upfront autologous stem cell transplantation in multiple myeloma

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Abstract

Plasmacytoma has been reported to be associated with a poor prognosis in patients with multiple myeloma (MM). In this study, we evaluated the incidence of relapse with plasmacytoma and survival outcomes after upfront autologous stem cell transplantation (ASCT). This study retrospectively analyzed the data of 303 patients with MM who underwent upfront ASCT between April 2000 and April 2018 at eight institutes in the Republic of Korea. In total, 52 patients (17.1%) had plasmacytoma at MM relapse after upfront ASCT, of whom, 27 had paramedullary plasmacytoma (PMD) and 25 had extramedullary plasmacytoma (EMD). Patients with initial plasmacytoma were more likely to have plasmacytoma at MM relapse than those without initial plasmacytoma (37.1% vs. 11.2%). Over a median follow-up of 66.0 months, patients with plasmacytoma at relapse had significantly inferior overall survival (OS) than those without plasmacytoma (43.9 vs. 100.7 months, P < 0.001), but the OS did not significantly differ between patients with EMD and those with PMD (42.2 vs. 56.6 months, P = 0.464). After MM relapse, all patients received salvage therapy, and progression-free survival after relapse was significantly shorter in patients with plasmacytoma than in those without (6.4 vs. 12.4 months, P = 0.007). This study showed that plasmacytoma frequently developed at MM relapse after upfront ASCT in patients with plasmacytoma at the time of diagnosis. Plasmacytoma at relapse was significantly associated with a poor prognosis.

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The dataset is available from the corresponding author upon reasonable request.

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Author notes

  1. Tan-Huy Chu and Sung-Hoon Jung contributed equally to this work.

Authors and Affiliations

  1. BioMedical Sciences Graduate Program, Chonnam National University, Gwangju, Republic of Korea

    Tan-Huy Chu & Je-Jung Lee

  2. Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 322 Seoyangro, Hwasun, Jeollanamdo, Seoul, 58128, Republic of Korea

    Tan-Huy Chu, Sung-Hoon Jung & Je-Jung Lee

  3. Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Kihyun Kim

  4. Gachon University Gil Medical Center, Incheon, Republic of Korea

    Jae Hoon Lee

  5. Ewha Womans University School of Medicine, Seoul, Republic of Korea

    Yeung-Chul Mun

  6. Seoul National University Bundang Hospital, Seoul, Republic of Korea

    Soo-Mee Bang

  7. Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Dok Hyun Yoon

  8. Kosin University Gospel Hospital, Busan, Republic of Korea

    Ho Sup Lee

  9. Department of Hematology, College of Medicine, Seoul St. Mary’s Hematology Hospital, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul, 137-070, Republic of Korea

    Chang-Ki Min

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  1. Tan-Huy Chu
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Contributions

CKM and JJL designed the study and THC and SHJ prepared the manuscript; KK, JHL, YCM, SMB, DHY, and HSL critically reviewed the manuscript. All authors have read and approved the final manuscript.

Corresponding authors

Correspondence to Chang-Ki Min or Je-Jung Lee.

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Ethics approval and consent to participate

This retrospective study was approved by the institutional ethics committee of each participating institution and conducted in accordance with the Declaration of Helsinki. The committee waived the need for informed patient consent because of the retrospective nature of the work.

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The authors declare no competing interests.

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The original version of this article was revised: In published article, the sentence "Please present P values consistently" was inadvertently included in the beginning of the abstract section.

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Chu, TH., Jung, SH., Kim, K. et al. Relapse with plasmacytoma after upfront autologous stem cell transplantation in multiple myeloma. Ann Hematol 101, 1217–1226 (2022). https://doi.org/10.1007/s00277-022-04776-0

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  • DOI: https://doi.org/10.1007/s00277-022-04776-0

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