scholarly journals Early relapse post autologous transplant is a stronger predictor of survival compared with pretreatment patient factors in the novel agent era: analysis of the Singapore Multiple Myeloma Working Group

2016 ◽  
Vol 51 (7) ◽  
pp. 933-937 ◽  
Author(s):  
S Y Ong ◽  
S de Mel ◽  
Y X Chen ◽  
M G Ooi ◽  
S Surendran ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Working Group ◽  
The Novel ◽  
Patient Factors ◽  
Early Relapse ◽  
Autologous Transplant ◽  
Novel Agent

Bortezomib Based Induction Is Superior to Thalidomide Based Induction in Reducing Early Relapses Following Upfront HDM: an Analysis By the Asian Myeloma Working Group

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4650-4650
Author(s):  
Sathish Kumar Gopalakrishnan ◽  
Shin-Yeu Ong ◽  
Seok Jin Kim ◽  
Hae Su Kim ◽  
Ji Yun Lee ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Working Group ◽  
Asian Population ◽  
Staging System ◽  
Early Relapse ◽  
Post Transplant ◽  
Autologous Transplant ◽  
Post Induction ◽  
Baseline Characteristics

Abstract Background: Multiple myeloma is a heterogeneous disease with certain genetic features associated with worse outcomes. The benefit of Bortezomib for high risk genetic patient subgroups remains unclear in an Asian population. We performed a retrospective analysis to compare bortezomib-based induction versus thalidomide-based induction in Asian patients who were treated with upfront autologous transplant. Methods: We retrospectively analyzed outcomes of 240 patients who received autologous transplant in two centers in Singapore (n=167) and one center in Korea (n=73) after bortezomib-based (n=120) versus thalidomide-based induction (n=120) between 2006 and 2014. Patients were staged according to International Staging System (ISS), and responses were defined according to International Myeloma Working Group criteria. Early relapse was defined as relapse within 12 months post-transplant. High risk cytogenetics included the presence of 17p13 deletion, t(14;16), or t(4;14) by FISH. Results: Baseline characteristics (age, gender, ISS, cytogenetics) were not significantly different between groups receiving bortezomib versus thalidomide induction. Bortezomib induction was associated with improved rates of complete response (CR) post-induction (40% vs 25%, p=0.013) and post-transplant (52% vs 48%, p=0.038). Median overall survival (OS) was prolonged with bortezomib (53 months vs 27 months, p=0.027). Multivariate analysis adjusted for baseline characteristics showed bortezomib reduced the risk of early relapse (HR 0.23, 95% CI 0.09-0.57, p=0.001), and improved overall survival (OS) (HR 0.2, 95% CI 041-0.93, p=0.021). Factors independently associated with poorer OS were high risk cytogenetics (HR 1.77, p=0.011), failure to achieve very good partial response (VGPR) or better post-induction (HR 1.70, p=0.005), early relapse (HR 6.20, p<0.001), but not advanced ISS stage or hypodiploidy karyotype. In subgroup analysis, patients with high-risk cytogenetics (n=46) who received bortezomib had improved OS (HR 0.39, CI 0.17 to 0.93, p=0.033), but patients with standard risk cytogenetics did not have significant OS benefit with bortezomib (HR 0.71, p=0.139). Conclusion: Our results suggest that despite upfront autologous stem cell transplantation, patients benefit from bortezomib versus thalidomide induction. Furthermore, bortezomib may be beneficial in overcoming the adverse prognostic effect of high-risk cytogenetics. Disclosures Durie: Janssen: Consultancy; Takeda: Consultancy; Amgen: Consultancy.

Multiple myeloma in octogenarians: Clinical features and outcome in the novel agent era

2012 ◽  
Vol 89 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Efstathios Kastritis ◽  
Sossana Delimpasi ◽  
Eirini Katodritou ◽  
Eleftheria Hatzimichael ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Clinical Features ◽  
The Novel ◽  
Novel Agent

Efficacy and Survival Outcome Associated with the Use of Novel Agents and Autologous Stem Cell Transplantation in Cases of Immunoglobulin D Multiple Myeloma in Korea

2018 ◽  
Vol 139 (3) ◽  
pp. 185-192 ◽  
Author(s):  
Jihoon Kang ◽  
Jung Yong Hong ◽  
Dok Hyun Yoon ◽  
Shin Kim ◽  
Kyoung Min Lee ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Maintenance Therapy ◽  
Autologous Stem Cell Transplantation ◽  
Novel Agents ◽  
Survival Outcomes ◽  
The Novel ◽  
Immunoglobulin D ◽  
Novel Agent

Background: Immunoglobulin D multiple myeloma (IgD MM) is characterized by a poor prognosis. Data are lacking on the survival benefits associated with the use of novel agents followed by autologous stem cell transplantation (ASCT) in IgD MM patients. We evaluated the clinical outcomes of induction treatment with novel agents followed by ASCT. Methods: This was a single-center, retrospective study of 22 IgD MM patients who underwent ASCT between 1995 and 2016. Of these, 10 (45.4%) received novel agents and 12 (54.6%) received nonnovel agents. Clinical features and survival outcomes were examined. Results: Median overall survival (OS) was 37.7 months in the 22 patients. Those in the novel-agents group received bortezomib or thalidomide-based regimens, whereas 91.7% of the nonnovel-agents group received a vincristine-based regimen. The median progression-free survival and OS in the novel-agent/nonnovel-agent groups were 8.3/7.4 and 38.6/12.5 months, respectively. The median OS of patients receiving maintenance therapy was not reached. Conclusion: This study showed improved survival outcomes compared to our previous study (37.7 vs. 12 months), suggesting that the use of a novel agent as induction and maintenance therapy may be beneficial in patients with IgD MM who undergo ASCT.

scholarly journals Transplant Outcomes and Early Relapse after Novel and Non-Novel Agent Induction: An Analysis By Singapore Myeloma Working Group

2016 ◽  
Vol 22 (3) ◽  
pp. S221
Author(s):  
Sathish Kumar Gopalakrishnan ◽  
Yun Xin Chen ◽  
Shin Yeu Ong ◽  
Sanjay de Mel ◽  
Colin Diong ◽  
...  
Keyword(s):  
Working Group ◽  
Early Relapse ◽  
Transplant Outcomes ◽  
Novel Agent

scholarly journals Relapsed/Progressive Disease and Its Prognostic Factors among Multiple Myeloma Patients Receiving Novel Agent Treatment in North East Peninsular Malaysia: A Single Centre Experience

2020 ◽  
Vol 27 (5) ◽  
pp. 62-77
Author(s):  
Hany Haqimi Wan Hanafi ◽  
Azlan Husin ◽  
Najib Majdi Yaacob ◽  
Abu Dzarr Abdullah
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Staging System ◽  
Peninsular Malaysia ◽  
Cell Transplant ◽  
The Novel ◽  
Ongoing Research ◽  
North East ◽  
Novel Agent

Background: Some multiple myeloma (MM) patients still relapse/progress despite novel agent therapy and relapse/progression in MM is therefore a vital area of ongoing research in the novel treatment era. This retrospective cohort study aimed to evaluate the time to relapse/ progression (TTP) among MM patients who received novel agents and to determine the associated prognostic factors. Methods: This study included 89 MM patients treated at Hospital Universiti Sains Malaysia. We analysed the TTP and the type of relapse/progression (biochemical versus clinical), and a Cox proportional hazard model was used to identify the significant prognostic factors. Results: Sixty-four percent of patients had biochemical relapse/progression. The overall median TTP among MM patients who received the novel agent(s) was 29.33 months (95% CI: 21.36–37.29). The type of paraprotein at diagnosis (P = 0.026, P = 0.228), International Staging System (ISS) score (P = 0.036, P = 0.067) and autologous stem cell transplant (ASCT) (P = 0.002) were prognostic factors for relapse/progression by simple Cox regression, but ASCT was the only significant predictor detected by multiple Cox regression (P = 0.003). Conclusion: Our study reflects the importance of paraprotein monitoring to detect early features of relapse/progression. ASCT is the most prognostic factor that may lengthen the TTP.

scholarly journals Efficacy and Safety of Novel Agent-Based Therapies for Multiple Myeloma: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-17 ◽  
Author(s):  
Xiaoxue Wang ◽  
Yan Li ◽  
Xiaojing Yan
Keyword(s):  
Multiple Myeloma ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Complete Response ◽  
The Novel ◽  
Efficacy And Safety ◽  
Free Survival ◽  
Agent Based ◽  
Randomized Controlled ◽  
Novel Agent

This study aimed at comparing bortezomib, thalidomide, and lenalidomide in patients with multiple myeloma (MM) for safety and efficacy using meta-analysis. This meta-analysis identified 17 randomized controlled trials (RCTs) including 6742 patients. These RCTs were separated according to the different agent-based regimens and to autologous stem-cell transplantation (ASCT). Complete response (CR), progression-free survival (PFS), overall survival (OS), and adverse events (AE) were combined. The total weighted risk ratio (RR) of CR was 3.29 [95% confidence interval (95% CI): 2.22–4.88] (P<0.0001) for the novel agent-based regimens. These novel agent-based regimens showed greater benefit in terms of PFS of all subgroups irrespective of whether the patient received ASCT or not. The hazard ratio (HR) for PFS was 0.64 [95% CI: 0.60–0.69] (P<0.00001). Improvements of OS could be found only in the bortezomib- and thalidomide-based regimens without ASCT. The pooled HRs were 0.74 [95% CI: 0.65–0.86] (P<0.0001) and 0.80 [95% CI: 0.70–0.90] (P=0.0004), respectively. Several AEs were shown more frequently in the novel agent-based regimens compared with controls such as hematologic events (neutropenia, anemia, and thrombocytopenia), gastrointestinal infection, peripheral neuropathy, thrombosis, and embolism events. In conclusion, in spite of the AEs, novel agent-based regimens are safe and effective for the treatment of MM.

scholarly journals Pembrolizumab, lenalidomide and dexamethasone post autologous transplant in patients with high‐risk multiple myeloma

2021 ◽  
Author(s):  
Noa Biran ◽  
Elli Gourna Paleoudis ◽  
Rena Feinman ◽  
David H. Vesole ◽  
Joshua Zenreich ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Autologous Transplant
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