Outcomes of Young Adults (Aged ≤ 40 Years) With Newly Diagnosed Multiple Myeloma After Up-Front Autologous Stem Cell Transplant

Authors

Oren Pasvolsky
Curtis Marcoux
Denái R Milton
Mark R Tanner
Qaiser Bashir
Samer Srour
Neeraj Saini
Paul Lin
Jeremy Ramdial
Yago Nieto
Hans C Lee
Krina K Patel
Partow Kebriaei
Priti Tewari
Lindsay Crawford-Suber
Sheeba K Thomas
Donna M Weber
Robert Z Orlowski
Elizabeth J Shpall
Richard E Champlin
Muzaffar H Qazilbash

Publication Date

8-1-2023

Journal

British Journal of Haematology

Abstract

Multiple myeloma (MM) primarily affects older patients. There are scarce data on the outcomes of young adults undergoing autologous transplantation (auto-HCT). In this single-centre analysis, we included 117 younger patients, with a median age of 37 years (range 22-40) at transplant. Seventeen (15%) patients had high-risk cytogenetics. Before transplant, 10% of patients achieved ≥CR and 44% achieved ≥VGPR. At best post-transplant response, 56% and 77% of patients achieved ≥CR and ≥VGPR respectively. With a median follow-up for survivors of 72.6 months (range 0.9-238.0), median PFS and OS were 43.1 months (95% CI 31.2-65.0) and 146.6 months (95% CI 100.0-208.1) respectively. Patients who underwent auto-HCT after 2010 had better median PFS (84.9 months vs. 28.2 months, p < 0.001) and OS (NR vs. 91.8 months, p < 0.001) compared with those transplanted earlier. In multi-variate analysis, achieving ≥CR as best post-transplant response was associated with improved PFS (HR [95% CI] 0.55 [0.32-0.95], p = 0.032), while achieving ≥VGPR was predictive of superior OS (0.32 [0.16-0.62], p < 0.001). Three patients (3%) developed a second primary malignancy. Younger MM patients had durable survival after auto-HCT, which further improved after the availability of novel anti-myeloma drugs in recent years. Depth of response following transplant remains a key predictor of survival.

Keywords

Humans, Young Adult, Adult, Multiple Myeloma, Treatment Outcome, Prognosis, Hematopoietic Stem Cell Transplantation, Stem Cell Transplantation, Transplantation, Autologous, Retrospective Studies

Comments

Supplementary Material

Data Availability Statement

PMID: 37376789

DOI

10.1111/bjh.18944

PMID

37376789

PMCID

PMC10527395

PubMedCentral® Posted Date

August 2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes