TY - JOUR
TI - Early Relapse After Autologous Transplant Is Associated With Very Poor Survival and Identifies an Ultra-High-Risk Group of Patients With Myeloma
AU - Kastritis, E.
AU - Roussou, M.
AU - Eleutherakis-Papaiakovou, E.
AU - Gavriatopoulou, M.
AU - Migkou, M.
AU - Gika, D.
AU - Fotiou, D.
AU - Kanellias, N.
AU - Ziogas, D.C.
AU - Ntanasis-Stathopoulos, I.
AU - Mparmparousi, D.
AU - Gatou, A.
AU - Katopi, D.
AU - Manios, E.
AU - Liontos, M.
AU - Giannouli, S.
AU - Tsirigotis, P.
AU - Terpos, E.
AU - Dimopoulos, M.A.
JO - Clinical Lymphoma Myeloma and Leukemia
PY - 2020
VL - 20
TODO - 7
SP - 445-452
PB - W B SAUNDERS CO-ELSEVIER INC
SN - null
TODO - 10.1016/j.clml.2019.10.014
TODO - bortezomib;  creatinine;  dexamethasone;  doxorubicin;  lactate dehydrogenase;  lenalidomide;  thalidomide;  vincristine, adult;  aged;  Article;  autotransplantation;  bone disease;  cancer recurrence;  cancer survival;  consolidation chemotherapy;  creatinine blood level;  cytogenetics;  female;  fluorescence in situ hybridization;  follow up;  glomerulus filtration rate;  high risk population;  human;  hypercalcemia;  induction chemotherapy;  International Staging System;  lactate dehydrogenase blood level;  maintenance therapy;  major clinical study;  male;  myeloma;  progression free survival;  recurrence risk;  retrospective study;  salvage therapy;  treatment response;  autotransplantation;  middle aged;  multiple myeloma;  pathology;  procedures;  risk factor;  young adult, Adult;  Aged;  Cytogenetics;  Female;  Humans;  Male;  Middle Aged;  Multiple Myeloma;  Retrospective Studies;  Risk Factors;  Transplantation, Autologous;  Young Adult
TODO - Introduction: Patients relapsing early after autologous stem cell transplantation (ASCT) are a particular therapeutic challenge. Methods: This was a retrospective, single center study that included 297 consecutive patients that received first-line ASCT Results: We identified 43 (14.5%) patients that relapsed within <12 months. At diagnosis, these patients had more often elevated lactate dehydrogenase, lower estimated glomerular filtration rate, hypercalcemia, and high-risk cytogenetics; the International Staging System stage distribution was similar. Consolidation and maintenance were associated with lower rates of early relapses. Progression-free survival to second-line therapy was 5 months versus 19 months for those with an early versus late relapse (P < .001), the median PFS to second-line therapy was 15.5 months versus >5 years (P < .001) and the median post-ASCT survival was 18 months versus >6 years. The survival after an early relapse has not improved significantly over time. In multivariate analysis, early relapse (hazard ratio, 14; P < .001) was the most important prognostic factor for poor survival after ASCT. Conclusion: Patients relapsing <12 months after ASCT comprise an ultra-high-risk group, with poor outcomes even with the application of the more recent combinations, that urgently needs more effective therapies. © 2019
Patients with myeloma who relapse early (within <12 months) after an autologous stem cell transplantation have a very poor outcome with a median post-transplant survival of just 18 months. Their outcome has not improved significantly over time. These patients with myeloma relapsing early after transplant comprise an ultra-high-risk group that urgently needs more effective therapies. © 2019
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