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

Abstract

Abbreviations: ASCT = autologous stem cell transplant; CR = complete response; IMiDs = immunomodulators; IMWG = International Myeloma Working Group; ORR = overall response rate; PI = proteasome inhibitors; PD = progressive disease; PR = partial response; VGPR = very good partial response; SCT = stem cell transplant. Best IMWG response was available for only 580 patients undergoing first line salvage therapy and 425 patients undergoing second line salvage therapy.

A new prognostic model for myeloma patients relapsing from upfront autologous transplantation based on ISS and PFS1

“…Our real‐world data echoes findings reported by other groups, indicating that early relapse is consistently associated with inferior outcomes (Jimenez‐Zepeda et al , ; Gonsalves et al , ; Majithia et al , ; Ong et al , ; Kumar et al , ). Pending validation in other patient cohorts, our risk model would be useful to stratify patients for clinical trials and may facilitate discussions with patients regarding prognosis at relapse.…”

The prognostic significance of polyclonal bone marrow plasma cells in patients with relapsing multiple myeloma

“…Finally, despite the availability of numerous laboratory‐based prognostic factors, clinical history remains an equally important determinant of overall clinical outcomes. For example, number of prior therapies is a well‐known prognostic factor that predicts for worse OS outcomes and shorter durations of response to subsequent therapies . In this study, having received more than 3 lines of prior therapy remained an especially powerful clinical indicator of chemo‐resistance in patients which subsequently translated to poor OS.…”

“…With the advent of immunomodulators (IMiDs) and proteasome inhibitors (PIs), as well as the incorporation of high dose chemotherapy followed by autologous stem cell transplantation (ASCT), the survival of patients with MM has greatly improved over the last decade . However, MM remains mostly incurable and most patients experience disease relapse with significant variability in terms of clinical features, response to therapy and overall survival (OS) due to the heterogeneous biology of the disease . Several prognostic markers have been studied to identify MM patients with high‐risk disease and poor OS, including cytogenetics, gene expression profiling, labeling index or S‐phase fraction, circulating clonal plasma cells, and the International Staging System (ISS) .…”

Prognostic value of minimal residual disease and polyclonal plasma cells in myeloma patients achieving a complete response to therapy

“…Multiple Myeloma (MM) is an incurable disease, with periods of remission, and eventual disease relapse. The fluctuating nature of this disease prompts exposure to several lines of therapy in an effort to prolong overall survival (OS), progression‐free survival (PFS), and time to next treatment (TTNT) . In an effort to risk stratify patients to aid in the selection of consolidation and maintenance therapies, several prognostic factors have been described.…”