BACKGROUND: Therapeutic options for patients with recurrent multiple myeloma after autologous stem cell transplantation (ASCT) include novel agents, conventional chemotherapy, or salvage ASCT with no standard of care. METHODS: A total of 200 patients with multiple myeloma who developed disease recurrence after treatment with upfront ASCT and received an autologous retransplantation as salvage therapy at the study center over a period of 15 years were retrospectively reviewed. The objective of the current study was to evaluate the role of salvage ASCT in terms of efficacy, particularly taking into account the impact of novel agents. RESULTS: The median progression-free survival (PFS) and overall survival after salvage ASCT were 15.2 months and 42.3 months, respectively. The overall response rate (a partial response or greater) was 80.4% at day 100, excluding 6 patients who died before assessment. Factors associated with improved PFS and overall survival after salvage ASCT included an initial PFS of > 18 months after upfront ASCT, bortezomib-containing or lenalidomide-containing therapies for reinduction, response to reinduction, and an International Staging System stage of I before salvage ASCT. CONCLUSIONS: Salvage ASCT is capable of achieving sustained disease control in patients with multiple myeloma. The use of lenalidomide and bortezomib for reinduction has improved the results after salvage ASCT, suggesting that novel agents and salvage ASCT are complementary rather than alternative treatment approaches.
BACKGROUND: Therapeutic options for patients with recurrent multiple myeloma after autologous stem cell transplantation (ASCT) include novel agents, conventional chemotherapy, or salvage ASCT with no standard of care. METHODS: A total of 200 patients with multiple myeloma who developed disease recurrence after treatment with upfront ASCT and received an autologous retransplantation as salvage therapy at the study center over a period of 15 years were retrospectively reviewed. The objective of the current study was to evaluate the role of salvage ASCT in terms of efficacy, particularly taking into account the impact of novel agents. RESULTS: The median progression-free survival (PFS) and overall survival after salvage ASCT were 15.2 months and 42.3 months, respectively. The overall response rate (a partial response or greater) was 80.4% at day 100, excluding 6 patients who died before assessment. Factors associated with improved PFS and overall survival after salvage ASCT included an initial PFS of > 18 months after upfront ASCT, bortezomib-containing or lenalidomide-containing therapies for reinduction, response to reinduction, and an International Staging System stage of I before salvage ASCT. CONCLUSIONS: Salvage ASCT is capable of achieving sustained disease control in patients with multiple myeloma. The use of lenalidomide and bortezomib for reinduction has improved the results after salvage ASCT, suggesting that novel agents and salvage ASCT are complementary rather than alternative treatment approaches.
Authors: T-F Wang; M A Fiala; A F Cashen; G L Uy; C N Abboud; T Fletcher; N Wu; P Westervelt; J F DiPersio; K E Stockerl-Goldstein; R Vij Journal: Bone Marrow Transplant Date: 2014-07-28 Impact factor: 5.483
Authors: Heinz Ludwig; Pieter Sonneveld; Faith Davies; Joan Bladé; Mario Boccadoro; Michele Cavo; Gareth Morgan; Javier de la Rubia; Michel Delforge; Meletios Dimopoulos; Hermann Einsele; Thierry Facon; Hartmut Goldschmidt; Philippe Moreau; Hareth Nahi; Torben Plesner; Jesús San-Miguel; Roman Hajek; Pia Sondergeld; Antonio Palumbo Journal: Oncologist Date: 2014-07-25
Authors: J Laubach; L Garderet; A Mahindra; G Gahrton; J Caers; O Sezer; P Voorhees; X Leleu; H E Johnsen; M Streetly; A Jurczyszyn; H Ludwig; U-H Mellqvist; W-J Chng; L Pilarski; H Einsele; J Hou; I Turesson; E Zamagni; C S Chim; A Mazumder; J Westin; J Lu; T Reiman; S Kristinsson; D Joshua; M Roussel; P O'Gorman; E Terpos; P McCarthy; M Dimopoulos; P Moreau; R Z Orlowski; J S Miguel; K C Anderson; A Palumbo; S Kumar; V Rajkumar; B Durie; P G Richardson Journal: Leukemia Date: 2015-12-29 Impact factor: 11.528
Authors: Sergio Giralt; Laurent Garderet; Brian Durie; Gordon Cook; Gosta Gahrton; Benedetto Bruno; Paremesweran Hari; Henk Lokhorst; Phillip McCarthy; Amrita Krishnan; Pieter Sonneveld; Harmut Goldschmidt; Sundar Jagannath; Bart Barlogie; Maria Mateos; Peter Gimsing; Orhan Sezer; Joseph Mikhael; Jin Lu; Meletios Dimopoulos; Amitabha Mazumder; Antonio Palumbo; Rafat Abonour; Kenneth Anderson; Michel Attal; Joan Blade; Jenny Bird; Michele Cavo; Raymond Comenzo; Javier de la Rubia; Hermann Einsele; Ramon Garcia-Sanz; Jens Hillengass; Sarah Holstein; Hans Erik Johnsen; Douglas Joshua; Guenther Koehne; Shaji Kumar; Robert Kyle; Xavier Leleu; Sagar Lonial; Heinz Ludwig; Hareth Nahi; Anil Nooka; Robert Orlowski; Vincent Rajkumar; Anthony Reiman; Paul Richardson; Eloisa Riva; Jesus San Miguel; Ingemar Turreson; Saad Usmani; David Vesole; William Bensinger; Muzaffer Qazilbash; Yvonne Efebera; Mohamed Mohty; Christina Gasparreto; James Gajewski; Charles F LeMaistre; Chris Bredeson; Phillipe Moreau; Marcelo Pasquini; Nicolaus Kroeger; Edward Stadtmauer Journal: Biol Blood Marrow Transplant Date: 2015-09-30 Impact factor: 5.742
Authors: Meletios A Dimopoulos; Paul G Richardson; Philippe Moreau; Kenneth C Anderson Journal: Nat Rev Clin Oncol Date: 2014-11-25 Impact factor: 66.675
Authors: Monika Engelhardt; Evangelos Terpos; Martina Kleber; Francesca Gay; Ralph Wäsch; Gareth Morgan; Michele Cavo; Niels van de Donk; Andreas Beilhack; Benedetto Bruno; Hans Erik Johnsen; Roman Hajek; Christoph Driessen; Heinz Ludwig; Meral Beksac; Mario Boccadoro; Christian Straka; Sara Brighen; Martin Gramatzki; Alessandra Larocca; Henk Lokhorst; Valeria Magarotto; Fortunato Morabito; Meletios A Dimopoulos; Hermann Einsele; Pieter Sonneveld; Antonio Palumbo Journal: Haematologica Date: 2014-02 Impact factor: 9.941