Abstract
We compared overall survival (OS) of 1017 patients with newly diagnosed multiple myeloma (MM) who were treated with different novel agent-based induction regimens and who underwent early autologous stem cell transplant (ASCT). Subgroups were defined by type of induction therapy: cyclophosphamide–bortezomib–dexamethasone (CyBorD; n=193), bortezomib–dexamethasone (Vd; n=64), lenalidomide–dexamethasone (Rd; n=251), bortezomib–lenalidomide–dexamethasone (VRd; n=126), thalidomide–dexamethasone (Td; n=155) and vincristine–doxorubicin–dexamethasone or dexamethasone alone (VAD/Dex; n=228). The median follow-up of the surviving patients was 66.7 months. The 5-year OS rates with CyBorD, Vd, Rd, VRd, Td and VAD/Dex were 79.2%, 72.3%, 79.2%, 79.0%, 57.4% and 63.4%, respectively (log-rank, P<0.001). In a multivariate analysis, after controlling for important patient and disease variables, VRd had a superior OS compared with CyBorD (hazard ratio (HR), 0.32; 95% confidence interval (CI), 0.10–0.88; P=0.03) and Vd (HR, 0.16; 95% CI, 0.04–0.52; P=0.002). In conclusion, our study demonstrates that among patients completing induction therapy and continuing to early transplant, VRd induction leads to improved OS compared with CyBorD and Vd regimens.
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S Kumar: Celgene (Consultancy and Research Funding), Millennium (Consultancy and Research Funding), Novartis (Research Funding), Onyx (Consultancy and Research Funding), AbbVie (Research Funding), Janssen (Consultancy and Research Funding) and BMS (Consultancy and Research Funding); A Dispenzieri: research funding (Celgene, Millennium, Pfizer and Janssen) and travel grant (Pfizer); P Kapoor: research funding from Millennium (Takeda), Celgene and Onyx (Amgen); MQ Lacy: research funding (Celgene); MA Gertz: Celgene (Honoraria), Millenium (Consultancy and Honoraria), Onyx (Honoraria), Novartis (Honoraria) and Smith Kline (Honoraria). The remaining authors declare no conflict of interest.
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Presented at the American Society of Hematology (ASH) 57th Annual Meeting and Exposition, Orlando, Florida, 5–8 December 2015.
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Chakraborty, R., Muchtar, E., Kumar, S. et al. The impact of induction regimen on transplant outcome in newly diagnosed multiple myeloma in the era of novel agents. Bone Marrow Transplant 52, 34–40 (2017). https://doi.org/10.1038/bmt.2016.214
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DOI: https://doi.org/10.1038/bmt.2016.214
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