Prognostic Impact of the Subcutaneous Adipose Tissue Loss on Survival Outcome in Patients with Multiple Myeloma

Abstract

28% were treated with a cytarabine-based induction regimen. Overall, 61% of pts received EAR and 39% received G-CSF based mobilization. 52% of pts received BEC (carmustine, etoposide, cyclophosphamide) and 45% BEAM (carmustine, etoposide, cytarabine, melphalan) conditioning. 34% of pts received 2 weekly doses of rituximab consolidation, 12% received maintenance rituximab, 19% maintenance rituximab and bortezomib (on clinical study), and 35% received no post-transplant therapy. 5-year PFS for the entire population was 57%. According to MIPI score, the 5-year PFS was 28% for those with a high MIPI score (6.2), 63% for intermediate (5.7-6.2), and 73% for low MIPI scores (<5.7). On univariate analysis, male gender (HR 2.89, 95% CI 1.31-6.39) and a high MIPI score (HR 3.6; 95% CI 1.51-8.57) were associated with an inferior PFS. There was no significant association between age at transplant (<60 vs. 60), or the various induction, mobilization, conditioning, or maintenance therapy strategies and PFS. On multivariate analysis, a high MIPI score (HR 4.51; 95% CI 1.51-13.48) and male gender (HR 4.98; 95% CI 1.48-16.73) were associated with an inferior PFS. Conclusions: Our single-center experience demonstrates that induction chemotherapy and ASCT provides significantly longer PFS in pts with low and intermediate MIPI scores. Age was not an independent predictor of PFS, and age 60 should not preclude the use of ASCT in MCL. Our data suggests that novel treatment strategies should be explored in the subset of pts with high MIPI scores.