Early Relapse post Autologous Transplant is Associated With Very Poor Survival and Identifies an Ultra High Risk Group of Myeloma Patients

Publication date: Available online 4 February 2020Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Efstathios Kastritis, Maria Roussou, Evangelos Eleutherakis-Papaiakovou, Maria Gavriatopoulou, Magdalini Migkou, Dimitra Gika, Despina Fotiou, Nikolaos Kanellias, Dimitrios C. Ziogas, Ioannis Ntanasis-Stathopoulos, Despoina Mparmparousi, Anastasia Gatou, Despina Katopi, Efstathios Manios, Michail Liontos, Stavroula Giannouli, Panagiotis Tsirigotis, Evangelos Terpos, Meletios A. DimopoulosAbstractPatients relapsing early after autologous stem cell transplantation (ASCT) are a particular therapeutic challenge. Among 297 consecutive patients receiving first-line ASCT, 43(14.5%) relapsed within <12 months. At diagnosis, these patients had more often elevated LDH, lower eGFR, hypercalcemia and high risk cytogenetics; ISS stage distribution was similar. Consolidation and maintenance were associated with lower rates of early relapses. PFS to 2nd line therapy was 5 vs 19 months for those with an early vs late relapse (p<0.001), the median PFS2 was 15.5 months vs>5 years (p<0.001) and median post-ASCT survival was 18 months vs> 6 years. The survival after an early relapse has not improved significantly over time. In multivariate analysis, early relapse (HR:14, p<0.001) was the most important prognostic factor for poor survival post ASCT. Thus, patients relapsing <12 months after ASCT comprise an ultra-high risk group, with poor outcomes even with the applicati...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research