Outcomes Have Improved Over Time in Myeloma Patients Relapsing Early After ASCT

Wayne Kuznar
Published: Saturday, Feb 25, 2017

Among the early relapsers, post-relapse survival was significantly superior in the 2 most recent time periods compared with 2001 to 2004 (P = .006). One-year post-relapse survival was 58%, 70%, and 68% in the groups receiving ASCT during 2001 to 2004, 2005 to 2008, and 2009 to 2013, respectively. At 3 years, the post-relapse survival rates were 32%, 42%, and 41%, respectively, and at 5 years, 22%, 25%, and 23%, respectively.

In assessing post-relapse survival by when patients relapsed, patients who relapsed in the more modern era (2008 or after) had significantly superior post-relapse survival (P <.01). Comparing patients who relapsed before 2008 to those who relapsed at 2008 or later, the 1-, 2-, 3-, and 5-year post-relapse survival rates in these 2 groups were 61% and 72%, 45% and 55%, 33% and 43%, and 21% and 26%.

Multivariate analysis showed that predictors of worse post-relapse survival were early relapse (P <.0001), IgA disease (P = .0002), ISS/DS stage III at diagnosis (P <.0001), receipt of 2 or more lines of chemotherapy (P = .0048), and Karnofsky score <90% (P = .0028). Receipt of a novel agent for maintenance predicted better post-relapse survival (P <.0001).
Dispenzieri A, Kumar S, Zhang M-J, et al Trends in survival outcomes among patients relapsing early after autologous stem cell transplantation for multiple myeloma (CIBMTR Study # MM14-03). Presented at: BMT Tandem Meetings; February 23-26, 2017; Orlando, Florida. Abstract 63.

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