Global characteristics and outcomes of autologous hematopoietic stem cell transplantation for newly diagnosed multiple myeloma: A study of the worldwide network for blood and marrow transplantation (WBMT)

Garderet, Laurent - Gras, Luuk - Koster, Linda - Riva, Eloísa - Galeano, Sebastián

Resumen:

Autologous hematopoietic cell transplantation (AHCT) is a commonly used treatment in multiple myeloma (MM). However, real-world global demographic and outcome data are scarce. We collected data on baseline characteristics and outcomes from 61 725 patients with newly diagnosed MM who underwent upfront AHCT between 2013 and 2017 from nine national/international registries. The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS), relapse incidence (RI) and non-relapse mortality (NRM). Median OS amounted to 90.2 months (95% CI 88.2-93.6) and median PFS 36.5 months (95% CI 36.1-37.0). At 24 months, cumulative RI was 33% (95% CI 32.5%-33.4%) and NRM was 2.5% (95% CI 2.3%-2.6%). In the multivariate analysis, superior outcomes were associated with younger age, IgG subtype, complete hematological response at auto-HCT, Karnofsky score of 100%, international staging scoring (ISS) stage 1, HCT-comorbidity index (CI) 0, standard cytogenetic risk, auto-HCT in recent years, and use of lenalidomide maintenance. There were differences in the baseline characteristics and outcomes between registries. While the NRM was 1%-3% at 12 months worldwide, the OS at 36 months was 69%-84%, RI at 12 months was 12%-24% and PFS at 36 months was 43%-63%. The variability in these outcomes is attributable to differences in patient and disease characteristics as well as the use of maintenance and macroeconomic factors. In conclusion, worldwide data indicate that AHCT in MM is a safe and effective therapy with an NRM of 1%-3% with considerable regional differences in OS, PFS, RI, and patient characteristics. Maintenance treatment post-AHCT had a beneficial effect on OS.

Detalles Bibliográficos
2024
ADULTO
ANCIANO
TRASPLANTE DE CÉLULAS MADRE HEMATOPOYÉTICAS
CÁLCULO DE DOSIFICACIÓN DE DROGAS
USOS TERAPÉUTICOS
LENALIDOMIDA
PERSONA DE MEDIANA EDAD
MIELOMA MÚLTIPLE
MORTALIDAD
TERAPÉUTICA
SISTEMA DE REGISTROS
TRASPLANTE AUTÓLOGO
TASA DE SUPERVIVENCIA
RESULTADO DEL TRATAMIENTO
Inglés
Universidad de la República
COLIBRI
https://hdl.handle.net/20.500.12008/56341
Acceso abierto
Licencia Creative Commons Atribución - No Comercial - Sin Derivadas (CC - By-NC-ND 4.0)
Resumen:
Sumario:Laurent Garderet 1, Luuk Gras 2, Linda Koster 3, Laurien Baaij 3, Nada Hamad 4, Anita Dsouza 5, Noel Estrada-Merly 6, Parameswaran Hari 7, Wael Saber 5, Andrew J Cowan 8, Minako Iida 9, Shinichiro Okamoto 10, Hiroyuki Takamatsu 11, Shohei Mizuno 12, Koji Kawamura 13, Yoshihisa Kodera 14, Bor-Sheng Ko 15, Christopher Liam 16, Kim Wah Ho 17, A Sim Goh 18, S Keat Tan 18, Alaa M Elhaddad 19, Ali Bazarbachi 20, Qamar Un Nisa Chaudhry 21, Rozan Alfar 22, Mohamed-Amine Bekadja 23, Malek Benakli 24, Cristobal Augusto Frutos Ortiz 25, Eloisa Riva 26, Sebastian Galeano 27, Francisca Bass 28, Hira S Mian 29, Arleigh McCurdy 30, Feng Rong Wang 31, Ly Meng 31, Daniel Neumann 32, Mickey Koh 33, John A Snowden 34, Stefan Schönland 35, Donal P McLornan 36, Patrick John Hayden 37, Anna Sureda 38, Hildegard T Greinix 39, Mahmoud Aljurf 40, Yoshiko Atsuta 41, Dietger Niederwieser 42