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Plasma Cell Disorders

Absence of spontaneous response improvement beyond day +100 after autologous stem cell transplantation in multiple myeloma

Bone Marrow Transplantation volume 52, pages 567–569 (2017)Cite this article

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Abstract

The response evaluation after autologous stem-cell transplantation (ASCT) is usually performed at day +100 in patients with multiple myeloma (MM). A recent report suggests that improvement in the response can be observed beyond day +100. The aim of the present study has been to evaluate the rate of improved response and outcome beyond day +100 after ASCT, with and without maintenance therapy. One hundred and forty-four patients who underwent single ASCT with chemosensitive disease and achieved less than CR at day 100 post ASCT were evaluated. Seventy-four patients (51.4%) did not receive any maintenance with only one of them showing an upgrade in the response. The remaining 70 patients (48.6%) received maintenance therapy; eleven of them (15.7%) improved their response beyond day +100. The outcome of these patients was better than those who did not upgrade their response in both progression-free survival and overall survival (P=0.019 and P=0.031, respectively). In conclusion, the improvement in response beyond day +100 after ASCT in patients not receiving any therapy is exceedingly rare. A minority of patients receiving maintenance therapy after ASCT upgrades their response and this finding is associated with better outcome.

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Acknowledgements

We thank Esther Bladé for her technical support in this research. This work has been supported in part by grants RD12/0036/0046, PI12/1093 and PI16/0423 from Instituto de Salud Carlos III and Fondo Europeo de Desarrollo Regional (FEDER), and 2014SGR-552 from AGAUR (Generalitat de Catalunya).

Author contributions

CFL, JD and EO designed the study, collected and analyzed the data, performed statistical analysis, wrote and reviewed the paper; II, LR, RGS, MTC, NT, MR, MVM, JSM and JB treated the patients, collected the data and reviewed the paper. All the authors approved the final version.

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Author notes

  1. C Fernández de Larrea and J Dávila: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clinic. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    C Fernández de Larrea, I Isola, L Rosiñol, M T Cibeira, N Tovar, M Rovira & J Bladé

  2. Department of Hematology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Centro de Investigación del Cáncer (IBMCC-USAL, CSIC), Salamanca, Spain

    J Dávila, E M Ocio, R García-Sanz & M V Mateos

  3. Clínica Universitaria de Navarra, Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain

    J S Miguel

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  1. C Fernández de Larrea
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  2. J Dávila
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  3. I Isola
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  4. E M Ocio
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  5. L Rosiñol
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  7. M T Cibeira
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  9. M Rovira
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  10. M V Mateos
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  12. J Bladé
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Correspondence to J Bladé.

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Fernández de Larrea, C., Dávila, J., Isola, I. et al. Absence of spontaneous response improvement beyond day +100 after autologous stem cell transplantation in multiple myeloma. Bone Marrow Transplant 52, 567–569 (2017). https://doi.org/10.1038/bmt.2016.299

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  • DOI: https://doi.org/10.1038/bmt.2016.299

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