Carfilzomib, lenalidomide and dexamethasone followed by a second ASCT is an effective strategy in first relapse multiple myeloma: a study on behalf of the Chronic malignancies working party of the EBMT
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Published:2023-08-05
Issue:11
Volume:58
Page:1182-1188
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ISSN:0268-3369
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Container-title:Bone Marrow Transplantation
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language:en
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Short-container-title:Bone Marrow Transplant
Author:
Tilmont RémiORCID, Yakoub-Agha Ibrahim, Eikema Diderik-Jan, Zinger Nienke, Haenel Mathias, Schaap Nicolaas, Arroyo Concepcion HerreraORCID, Schuermans Christine, Besemer Britta, Engelhardt MonikaORCID, Kuball JürgenORCID, Michieli Mariagrazia, Schub Natalie, Wilson Keith M. O., Bourhis Jean Henri, Mateos Maria VictoriaORCID, Rabin Neil, Jost Edgar, Kröger NicolausORCID, Moraleda José MORCID, Za Tommaso, Hayden Patrick J.ORCID, Beksac MeralORCID, Mclornan DonalORCID, Schönland StefanORCID, Manier SalomonORCID
Abstract
AbstractIn the setting of a first relapse of multiple myeloma (MM), a second autologous stem cell transplant (ASCT) following carfilzomib-lenalidomide-dexamethasone (KRd) is an option, although there is scarce data concerning this approach. We performed a retrospective study involving 22 EBMT-affiliated centers. Eligible MM patients had received a second-line treatment with KRd induction followed by a second ASCT between 2016 and 2018. Primary objective was to estimate progression-free survival (PFS) and overall survival (OS). Secondary objectives were to assess the response rate and identify significant variables affecting PFS and OS. Fifty-one patients were identified, with a median age of 62 years. Median PFS after ASCT was 29.5 months while 24- and 36-months OS rates were 92.1% and 84.5%, respectively. Variables affecting PFS were an interval over four years between transplants and the achievement of a very good partial response (VGPR) or better before the relapse ASCT. Our study suggests that a relapse treatment with ASCT after KRd induction is an effective strategy for patients with a lenalidomide-sensitive first relapse. Patients with at least four years of remission after a frontline ASCT and who achieved at least a VGPR after KRd induction appear to benefit the most from this approach.
Publisher
Springer Science and Business Media LLC
Subject
Transplantation,Hematology
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