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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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. / Tilmont, Rémi; Yakoub-Agha, Ibrahim; Eikema, Diderik-Jan; Zinger, Nienke; Haenel, Mathias; Schaap, Nicolaas; Arroyo, Concepcion Herrera; Schuermans, Christine; Besemer, Britta; Engelhardt, Monika; Kuball, Jürgen; Michieli, Mariagrazia; Schub, Natalie; Wilson, Keith M O; Bourhis, Jean Henri; Mateos, Maria Victoria; Rabin, Neil; Jost, Edgar; Kröger, Nicolaus; Moraleda, José M; Za, Tommaso; Hayden, Patrick J; Beksac, Meral; Mclornan, Donal; Schönland, Stefan; Manier, Salomon.
in: BONE MARROW TRANSPL, Jahrgang 58, Nr. 11, 11.2023, S. 1182-1188.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - 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
AU - Tilmont, Rémi
AU - Yakoub-Agha, Ibrahim
AU - Eikema, Diderik-Jan
AU - Zinger, Nienke
AU - Haenel, Mathias
AU - Schaap, Nicolaas
AU - Arroyo, Concepcion Herrera
AU - Schuermans, Christine
AU - Besemer, Britta
AU - Engelhardt, Monika
AU - Kuball, Jürgen
AU - Michieli, Mariagrazia
AU - Schub, Natalie
AU - Wilson, Keith M O
AU - Bourhis, Jean Henri
AU - Mateos, Maria Victoria
AU - Rabin, Neil
AU - Jost, Edgar
AU - Kröger, Nicolaus
AU - Moraleda, José M
AU - Za, Tommaso
AU - Hayden, Patrick J
AU - Beksac, Meral
AU - Mclornan, Donal
AU - Schönland, Stefan
AU - Manier, Salomon
N1 - © 2023. The Author(s).
PY - 2023/11
Y1 - 2023/11
N2 - In 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.
AB - In 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.
KW - Humans
KW - Middle Aged
KW - Multiple Myeloma/drug therapy
KW - Lenalidomide/pharmacology
KW - Retrospective Studies
KW - Treatment Outcome
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Neoplasm Recurrence, Local/drug therapy
KW - Dexamethasone/therapeutic use
KW - Transplantation, Autologous
U2 - 10.1038/s41409-023-02048-7
DO - 10.1038/s41409-023-02048-7
M3 - SCORING: Journal article
C2 - 37543712
VL - 58
SP - 1182
EP - 1188
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 11
ER -