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Clinical course and outcomes of patients with multiple myeloma who relapse after autologous stem cell therapy

Bone Marrow Transplantation volume 51, pages 1156–1158 (2016)Cite this article

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Autologous stem cell transplant (ASCT) remains an integral part of the treatment of eligible patients with multiple myeloma (MM). It is usually performed either in the upfront setting as consolidation after induction therapy or in a delayed fashion for management of relapsed disease. Unfortunately, disease relapse or progression of disease post ASCT remain inevitable for most patients irrespective of the timing of the ASCT.1, 2 However, the clinical features at the time of relapse and subsequent clinical outcomes are quite heterogeneous amongst these patients. This information is particularly important given that it may provide new benchmarks when comparing different therapies in the post-ASCT relapse setting in clinical trials. It can also identify subsets of patients who are at the risk of having poor outcomes upon relapse post ASCT in order to study the utility of treating them with more intensive or novel therapies. This study describes the natural history of the disease and survival outcomes at the time of relapse or disease progression in patients with MM who received an ASCT as part of their treatment either in the upfront or delayed setting.

A total of 672 MM patients who had undergone an ASCT had experienced a documented relapse or disease progression between 1 January 2000 and 31 December 2012. Of these patients, 468 (70%) underwent an upfront ASCT defined as an ASCT within 1 year from the diagnosis of MM, whereas the remaining 204 patients had a delayed ASCT which was defined as an ASCT performed at least 1 year or more from the diagnosis of MM. The median estimated follow-up for this entire cohort from diagnosis was 149 months (95% CI: 135–159) and from first relapse post ASCT was 94 months (95% CI: 84–106).

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Acknowledgements

This work is supported by the Mayo Clinic Hematological Malignancies Program. It is also supported in part by the Jabbs Foundation, Birmingham, United Kingdom and the Henry J Predolin Foundation, USA, as well as the CTSA Grant UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH).

Author contributions

SKK and WIG designed the study, collected the data, analyzed the data and wrote the manuscript; SVR, MAG, AD, MQL, FKB, DD, NL, RAK, JAL, SJR, SRZ, SRH, YLH, TVK, RSG and PK contributed to writing and reviewing the manuscript.

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Authors and Affiliations

  1. Division of Hematology, Mayo Clinic, Rochester, MN, USA

    W I Gonsalves, S V Rajkumar, M A Gertz, A Dispenzieri, M Q Lacy, F K Buadi, D Dingli, R S Go, N Leung, P Kapoor, S R Hayman, J A Lust, S J Russell, S R Zeldenrust, Y L Hwa, T V Kourelis, R A Kyle & S K Kumar

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  1. W I Gonsalves
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  2. S V Rajkumar
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  3. M A Gertz
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  4. A Dispenzieri
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  5. M Q Lacy
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  6. F K Buadi
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  7. D Dingli
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  8. R S Go
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  9. N Leung
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  10. P Kapoor
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  11. S R Hayman
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  12. J A Lust
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  13. S J Russell
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  14. S R Zeldenrust
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  15. Y L Hwa
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  16. T V Kourelis
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  17. R A Kyle
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  18. S K Kumar
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Corresponding author

Correspondence to S K Kumar.

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Gonsalves, W., Rajkumar, S., Gertz, M. et al. Clinical course and outcomes of patients with multiple myeloma who relapse after autologous stem cell therapy. Bone Marrow Transplant 51, 1156–1158 (2016). https://doi.org/10.1038/bmt.2016.91

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