Τίτλος:
Early Relapse After Autologous Transplant Is Associated With Very Poor Survival and Identifies an Ultra-High-Risk Group of Patients With Myeloma
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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
Συγγραφείς:
Kastritis, E.
Roussou, M.
Eleutherakis-Papaiakovou, E.
Gavriatopoulou, M.
Migkou, M.
Gika, D.
Fotiou, D.
Kanellias, N.
Ziogas, D.C.
Ntanasis-Stathopoulos, I.
Mparmparousi, D.
Gatou, A.
Katopi, D.
Manios, E.
Liontos, M.
Giannouli, S.
Tsirigotis, P.
Terpos, E.
Dimopoulos, M.A.
Περιοδικό:
Clinical Lymphoma Myeloma and Leukemia
Εκδότης:
W B SAUNDERS CO-ELSEVIER INC
Λέξεις-κλειδιά:
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
DOI:
10.1016/j.clml.2019.10.014
