Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Annals of Hematology |
| DOIs | |
| Publication status | Accepted/In press - Oct 24 2017 |
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Keywords
- Multiple myeloma
- Novel agents
- Outcomes
- Relapse
- Salvage autologous stem cell transplantation
Cite this
Novel agent-based salvage autologous stem cell transplantation for relapsed multiple myeloma. / Zannetti, Beatrice Anna; Tacchetti, Paola; Pantani, Lucia; Gamberi, Barbara; Tosi, Patrizia; Rocchi, Serena; Cellini, Claudia; Ronconi, Sonia; Pezzi, Annalisa; Mancuso, Katia; Rizzello, Ilaria; Caratozzolo, Isola; Martello, Marina; Dozza, Luca; Cavo, Michele; Zamagni, Elena.
In: Annals of Hematology, 24.10.2017, p. 1-8.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Novel agent-based salvage autologous stem cell transplantation for relapsed multiple myeloma
AU - Zannetti, Beatrice Anna
AU - Tacchetti, Paola
AU - Pantani, Lucia
AU - Gamberi, Barbara
AU - Tosi, Patrizia
AU - Rocchi, Serena
AU - Cellini, Claudia
AU - Ronconi, Sonia
AU - Pezzi, Annalisa
AU - Mancuso, Katia
AU - Rizzello, Ilaria
AU - Caratozzolo, Isola
AU - Martello, Marina
AU - Dozza, Luca
AU - Cavo, Michele
AU - Zamagni, Elena
PY - 2017/10/24
Y1 - 2017/10/24
N2 - 2017 Springer-Verlag GmbH Germany High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a standard frontline therapy for multiple myeloma (MM). Therapeutic options for patients with relapsed MM after ASCT include novel agents in different combos, salvage ASCT (sASCT), and allogeneic transplant, with no unique standard of care. We retrospectively analyzed 66 MM patients who relapsed after up-front single or double ASCT(s) and received novel agent-based sASCT at five Italian centers. Median event-free survival from up-front ASCT(s) to first relapse (EFS1) was 44 months. Seventy-three percent of patients received sASCT at first disease progression. Re-induction regimens were bortezomib based in 87% of patients. Response to re-induction therapy included complete response (CR) 18%, ≥ very good partial response (VGPR) 48%, and overall response rate (ORR) 83%. Response to sASCT included CR 44%, ≥ VGPR 77%, and ORR 94%. With a median follow-up of 24 months after sASCT, 39 patients experienced disease progression. Median EFS from sASCT (EFS2) was 17 months. Median overall survival from ASCT (OS1) and sASCT (OS2) was 166 and 43 months, respectively. EFS2 and OS2 were significantly shorter in patients with EFS1 ≤ 24 months, in patients who did not receive sASCT at first disease progression and in patients with extramedullary disease (EMD). In multivariate analysis, EFS1 ≤ 24 months was associated with shorter EFS2 and OS2, EMD was associated with shorter EFS2, and < CR after sASCT was associated with shorter OS2. Novel agent-based sASCT is a safe and effective procedure for relapsed MM.
AB - 2017 Springer-Verlag GmbH Germany High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a standard frontline therapy for multiple myeloma (MM). Therapeutic options for patients with relapsed MM after ASCT include novel agents in different combos, salvage ASCT (sASCT), and allogeneic transplant, with no unique standard of care. We retrospectively analyzed 66 MM patients who relapsed after up-front single or double ASCT(s) and received novel agent-based sASCT at five Italian centers. Median event-free survival from up-front ASCT(s) to first relapse (EFS1) was 44 months. Seventy-three percent of patients received sASCT at first disease progression. Re-induction regimens were bortezomib based in 87% of patients. Response to re-induction therapy included complete response (CR) 18%, ≥ very good partial response (VGPR) 48%, and overall response rate (ORR) 83%. Response to sASCT included CR 44%, ≥ VGPR 77%, and ORR 94%. With a median follow-up of 24 months after sASCT, 39 patients experienced disease progression. Median EFS from sASCT (EFS2) was 17 months. Median overall survival from ASCT (OS1) and sASCT (OS2) was 166 and 43 months, respectively. EFS2 and OS2 were significantly shorter in patients with EFS1 ≤ 24 months, in patients who did not receive sASCT at first disease progression and in patients with extramedullary disease (EMD). In multivariate analysis, EFS1 ≤ 24 months was associated with shorter EFS2 and OS2, EMD was associated with shorter EFS2, and < CR after sASCT was associated with shorter OS2. Novel agent-based sASCT is a safe and effective procedure for relapsed MM.
KW - Multiple myeloma
KW - Novel agents
KW - Outcomes
KW - Relapse
KW - Salvage autologous stem cell transplantation
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U2 - 10.1007/s00277-017-3140-5
DO - 10.1007/s00277-017-3140-5
M3 - Article
SP - 1
EP - 8
JO - Annals of Hematology
JF - Annals of Hematology
SN - 0939-5555
ER -