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Early relapse after autologous hematopoietic cell transplantation remains a poor prognostic factor in multiple myeloma but outcomes have improved over time.

Publication ,  Journal Article
Kumar, SK; Dispenzieri, A; Fraser, R; Mingwei, F; Akpek, G; Cornell, R; Kharfan-Dabaja, M; Freytes, C; Hashmi, S; Hildebrandt, G; Holmberg, L ...
Published in: Leukemia
April 2018

Duration of initial disease response remains a strong prognostic factor in multiple myeloma (MM) particularly for upfront autologous hematopoietic cell transplant (AHCT) recipients. We hypothesized that new drug classes and combinations employed prior to AHCT as well as after post-AHCT relapse may have changed the natural history of MM in this population. We analyzed the Center for International Blood and Marrow Transplant Research database to track overall survival (OS) of MM patients receiving single AHCT within 12 months after diagnosis (N=3256) and relapsing early post-AHCT (<24 months), and to identify factors predicting for early vs late relapses (24-48 months post-AHCT). Over three periods (2001-2004, 2005-2008, 2009-2013), patient characteristics were balanced except for lower proportion of Stage III, higher likelihood of one induction therapy with novel triplets and higher rates of planned post-AHCT maintenance over time. The proportion of patients relapsing early was stable over time at 35-38%. Factors reducing risk of early relapse included lower stage, chemosensitivity, transplant after 2008 and post-AHCT maintenance. Shorter post-relapse OS was associated with early relapse, IgA MM, Karnofsky <90, stage III, >1 line of induction and lack of maintenance. Post-AHCT early relapse remains a poor prognostic factor, even though outcomes have improved over time.

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Published In

Leukemia

DOI

EISSN

1476-5551

Publication Date

April 2018

Volume

32

Issue

4

Start / End Page

986 / 995

Location

England

Related Subject Headings

  • Young Adult
  • Transplantation, Autologous
  • Recurrence
  • Prognosis
  • Neoplasm Recurrence, Local
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Immunology
  • Immunoglobulin A
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kumar, S. K., Dispenzieri, A., Fraser, R., Mingwei, F., Akpek, G., Cornell, R., … D’Souza, A. (2018). Early relapse after autologous hematopoietic cell transplantation remains a poor prognostic factor in multiple myeloma but outcomes have improved over time. Leukemia, 32(4), 986–995. https://doi.org/10.1038/leu.2017.331
Kumar, S. K., A. Dispenzieri, R. Fraser, F. Mingwei, G. Akpek, R. Cornell, M. Kharfan-Dabaja, et al. “Early relapse after autologous hematopoietic cell transplantation remains a poor prognostic factor in multiple myeloma but outcomes have improved over time.Leukemia 32, no. 4 (April 2018): 986–95. https://doi.org/10.1038/leu.2017.331.
Kumar SK, Dispenzieri A, Fraser R, Mingwei F, Akpek G, Cornell R, et al. Early relapse after autologous hematopoietic cell transplantation remains a poor prognostic factor in multiple myeloma but outcomes have improved over time. Leukemia. 2018 Apr;32(4):986–95.
Kumar, S. K., et al. “Early relapse after autologous hematopoietic cell transplantation remains a poor prognostic factor in multiple myeloma but outcomes have improved over time.Leukemia, vol. 32, no. 4, Apr. 2018, pp. 986–95. Pubmed, doi:10.1038/leu.2017.331.
Kumar SK, Dispenzieri A, Fraser R, Mingwei F, Akpek G, Cornell R, Kharfan-Dabaja M, Freytes C, Hashmi S, Hildebrandt G, Holmberg L, Kyle R, Lazarus H, Lee C, Mikhael J, Nishihori T, Tay J, Usmani S, Vesole D, Vij R, Wirk B, Krishnan A, Gasparetto C, Mark T, Nieto Y, Hari P, D’Souza A. Early relapse after autologous hematopoietic cell transplantation remains a poor prognostic factor in multiple myeloma but outcomes have improved over time. Leukemia. 2018 Apr;32(4):986–995.

Published In

Leukemia

DOI

EISSN

1476-5551

Publication Date

April 2018

Volume

32

Issue

4

Start / End Page

986 / 995

Location

England

Related Subject Headings

  • Young Adult
  • Transplantation, Autologous
  • Recurrence
  • Prognosis
  • Neoplasm Recurrence, Local
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Immunology
  • Immunoglobulin A