Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Aug;3(4):939-46.
doi: 10.1002/cam4.257. Epub 2014 Apr 29.

Complete response after autologous stem cell transplant in multiple myeloma

Lalit Kumar  1 , Nida Iqbal, Anjali Mookerjee, Rakesh Kumar Verma, Om D Sharma, Atul Batra, Raja Pramanik, Ritu Gupta
Affiliations

Complete response after autologous stem cell transplant in multiple myeloma

Lalit Kumar et al. Cancer Med. 2014 Aug.

Abstract

We evaluated long-term outcome of patients achieving complete response (CR) after autologous stem cell transplantation (ASCT) for multiple myeloma. Between April 1990 and June 2012 191 patients underwent ASCT. The median age was 53 years (range, 26-68 years), 135 were men. Pretransplant, patients received induction therapy with VAD (vincristine, doxorubicin, dexamethasone; n = 77), novel agents (n = 92), or alkylating agent-based, n = 22); 43% received more than one line of induction regimen. Response to transplant was defined as per EBMT criteria. The median follow-up for the entire group was 85 months (range, 6-232.5 months). Following transplant 109 (57.1%) patients achieved CR. Median progression-free survival (PFS) for patients with CR was higher compared to those with VGPR and PR, (107 vs. 18 vs. 18 months, P < 0.001). Number of lines of therapy pretransplant (one or two vs. more than two lines of therapy (P < 0.001), and absolute lymphocyte count of ≤ 3000/cmm were predictors of superior PFS. Median overall survival (OS) for patients with CR was higher, (204 months), compared to those with VGPR (71.5 months, P < 0.001) and PR (51.5 months, P < 0.001), respectively. On Cox regression analysis, patients who received one line of induction therapy pretransplant (hazard ratio, HR 2.154, P < 0.001) and those with absolute lymphocyte count of ≤ 3000/mm(3) (HR 0.132, P < 0.001) had superior PFS. For overall survival, induction treatment up to one line (HR 2.403, P < 0.004) and Hb > 7.1 G/dL at diagnosis (HR 4.756, P < 0.01) were associated with superior outcome. On landmark analysis at 12 months, PFS and OS continued to remain superior for patients attaining CR. Achievement of CR post transplant is associated with longer OS and PFS. Among complete responders, those who receive one line of induction therapy pretransplant have superior outcome.

Keywords: Autologous stem cell transplant; complete response; multiple myeloma; pretransplant therapy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overall survival according to response to transplant.
Figure 2
Figure 2
Progression-free survival according to response to transplant.
See this image and copyright information in PMC

References

    1. Koreth J, Cutler CS, Djulbegovic B, Behl R, Schlossman RL. Munshi NC, et al. High-dose therapy with single autologous transplantation versus chemotherapy for newly diagnosed multiple myeloma: a systematic review and meta-analysis of randomized controlled trials. Biol. Blood Marrow Transplant. 2007;13:183–196. - PubMed
    1. Blade J, Rosinol L, Cibeira MT, Rovira M. Carreras E. Hematopoietic stem cell transplantation for multiple myeloma beyond 2010. Blood. 2010;115:3655–3663. - PubMed
    1. Harousseau JL, Attal M. Avet-Loiseau H. The role of complete response in multiple myeloma. Blood. 2009;114:3139–3146. - PubMed
    1. Lahuerta JJ, Mateos MV, Martínez-López J, Rosiñol L, Sureda A, de la Rubia J, et al. Influence of pre- and post-transplantation responses on outcome of patients with multiple myeloma: sequential improvement of response and achievement of complete response are associated with longer survival. J. Clin. Oncol. 2008;26:5775–5782. - PubMed
    1. van de Velde HJ, Liu X, Chen G, Cakana A, Deraedt W. Bayssas M. Complete response correlates with long-term survival and progression-free survival in high-dose therapy in multiple myeloma. Haematologica. 2007;92:1399–1406. - PubMed

Publication types