Blood Cancer Journal (May 2024)

Multiple myeloma patients with a long remission after autologous hematopoietic stem cell transplantation

  • Oren Pasvolsky,
  • Zhongya Wang,
  • Denái R. Milton,
  • Mark R. Tanner,
  • Qaiser Bashir,
  • Samer Srour,
  • Neeraj Saini,
  • Paul Lin,
  • Jeremy Ramdial,
  • Yago Nieto,
  • Guilin Tang,
  • Partow Kebriaei,
  • Yosra Aljawai,
  • Hina N. Khan,
  • Hans C. Lee,
  • Christine Ye,
  • Krina K. Patel,
  • Sheeba K. Thomas,
  • Robert Z. Orlowski,
  • Elizabeth J. Shpall,
  • Richard E. Champlin,
  • Muzaffar H. Qazilbash

DOI
https://doi.org/10.1038/s41408-024-01062-2
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 7

Abstract

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Abstract Autologous stem cell transplantation (autoHCT) is considered standard of care for newly diagnosed multiple myeloma (MM). Although most patients eventually progress after autoHCT, a small proportion achieve a durable response. In this retrospective study we included 1576 patients, 244 (15%) of whom were long-term responders (LTR), defined as having a progression-free survival (PFS) of ≥8 years after transplant. Patients in the LTR group were younger than the non-LTR group (median age 58.4 vs. 59.5 years; p = 0.012), less likely to have high-risk cytogenetics (4% vs. 14%; p < 0.001), more often had <50% bone marrow plasma cells (67% vs. 58%; p = 0.018) and R-ISS stage I disease (43% vs. 34%). More patients in the LTR group received post-transplant maintenance (63% vs. 52%; p = 0.002). Patients in the LTR group had higher rates of complete response (CR) at day100 (41% vs. 27%; p < 0.001) and at best post-transplant response (70% vs. 37%; p < 0.001), compared to the non-LTR group. Patients in the LTR groups had a median PFS of 169.3 months and the median overall survival (OS) had not been reached. The leading cause of death in the LTR was disease progression. In conclusion, 15% of patients in the cohort were LTR after upfront autoHCT, with distinct characteristics and a median PFS of more than 14 years.