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Impact of failed response to novel agent induction in autologous stem cell transplantation for multiple myeloma

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Abstract

The aim of this study was to evaluate the impact of the response to induction therapy on the long-term prognosis of multiple myeloma (MM) after autologous stem cell transplantation (ASCT) in the era of novel agents (NAs). A total of 171 patients who were newly diagnosed with MM and underwent early ASCT were analyzed. One hundred ten had a NA-based induction therapy, and 61 patients had a non-NA-based induction therapy. After a median follow-up of 45.4 months, the 4-year overall survival (OS) and progression-free survival (PFS) from transplantation were 60.5 and 25.5 %, respectively, for the NA-based induction group and 54.6 and 15.6 %, respectively, for the non-NA-based induction group. Multivariate analyses revealed that the patients who had NA-based induction had a significantly shorter OS (P < 0.001) and PFS (P < 0.001) when at least a partial response (PR) was not achieved. In patients who did not receive NAs before ASCT, lack of at least a PR to induction therapy was not associated with a survival disadvantage. These findings suggest that, unlike pretransplantation induction before NAs, patients who do not respond to induction treatment using NAs may not derive a benefit from ASCT. The relevance of induction failure differs for corticosteroid- and NA-based induction.

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Acknowledgments

The authors acknowledge all members of the Catholic Blood and Marrow Transplantation Center, particularly the house staff, for their excellent care of the patients. This study was supported by the Korea Healthcare Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (grant no. HIA130000).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Hematology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #505, Banpo-dong, Seocho-gu, Seoul, 37-701, South Korea

    Sung-Eun Lee, Jae-Ho Yoon, Seung-Hwan Shin, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Hee-Je Kim, Seok Lee, Seok-Goo Cho, Dong-Wook Kim, Jong-Wook Lee, Woo-Sung Min, Chong-Won Park & Chang-Ki Min

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  1. Sung-Eun Lee
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  2. Jae-Ho Yoon
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  14. Chang-Ki Min
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Correspondence to Chang-Ki Min.

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Online resource Figure 1

Long-term outcomes according to detailed pretransplant responses. In the NA-based group, (A) overall survival and (B) progression-free survival. In the non-NA-based group, (C) overall survival and (D) progression-free survival (JPEG 174 kb)

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Lee, SE., Yoon, JH., Shin, SH. et al. Impact of failed response to novel agent induction in autologous stem cell transplantation for multiple myeloma. Ann Hematol 93, 627–634 (2014). https://doi.org/10.1007/s00277-013-1911-1

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  • DOI: https://doi.org/10.1007/s00277-013-1911-1

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