Impact of extramedullary disease in patients with newly diagnosed multiple myeloma undergoing autologous stem cell transplantation: A study from the Chronic Malignancies Working Party of the EBMT

TY - JOUR

T1 - Impact of extramedullary disease in patients with newly diagnosed multiple myeloma undergoing autologous stem cell transplantation: A study from the Chronic Malignancies Working Party of the EBMT

AU - Gagelmann, Nico

AU - Eikema, Diderik-Jan

AU - Iacobelli, Simona

AU - Koster, Linda

AU - Nahi, Hareth

AU - Stoppa, Anne-Marie

AU - Masszi, Tamás

AU - Caillot, Denis

AU - Lenhoff, Stig

AU - Udvardy, Miklos

AU - Crawley, Charles

AU - Arcese, William

AU - Mariette, Clara

AU - Hunter, Ann

AU - Leleu, Xavier

AU - Schipperus, Martin

AU - Delforge, Michel

AU - Pioltelli, Pietro

AU - Snowden, John A

AU - Itälä-Remes, Maija

AU - Musso, Maurizio

AU - van Biezen, Anja

AU - Garderet, Laurent

AU - Kröger, Nicolaus

N1 - Copyright © 2018, Ferrata Storti Foundation.

PY - 2018/5

Y1 - 2018/5

N2 - We investigated extramedullary disease in newly diagnosed multiple myeloma patients and its impact on outcome following first-line autologous stem cell transplantation. We identified 3744 adult myeloma patients who received up-front single (n=3391) or tandem transplantation (n=353) between 2005 and 2014 with available data on extramedullary involvement at diagnosis. The overall incidence of extramedullary disease was 18.2% (n=682) and increased per year from 6.5% (2005) to 23.7% (2014). Paraskeletal involvement was found in 543 (14.5%) and extramedullary organ involvement in 139 (3.7%). More patients with extramedullary organ involvement had multiple involved sites (≥2; P<0.001). In a comparison of patients with single sites with patients without the disease, up-front transplantation resulted in at least similar 3-year progression-free survival (paraskeletal: P=0.86, and extramedullary organ: P=0.88). In single paraskeletal involvement, this translated less clearly into worse 3-year overall survival (P=0.07) while single organ involvement was significantly worse (P=0.001). Multiple organ sites were associated with worse outcome (P<0.001 and P=0.01). First-line treatment with tandem compared with single transplantation resulted in similar survival in patients with extramedullary disease at diagnosis (P=0.13 for both).

AB - We investigated extramedullary disease in newly diagnosed multiple myeloma patients and its impact on outcome following first-line autologous stem cell transplantation. We identified 3744 adult myeloma patients who received up-front single (n=3391) or tandem transplantation (n=353) between 2005 and 2014 with available data on extramedullary involvement at diagnosis. The overall incidence of extramedullary disease was 18.2% (n=682) and increased per year from 6.5% (2005) to 23.7% (2014). Paraskeletal involvement was found in 543 (14.5%) and extramedullary organ involvement in 139 (3.7%). More patients with extramedullary organ involvement had multiple involved sites (≥2; P<0.001). In a comparison of patients with single sites with patients without the disease, up-front transplantation resulted in at least similar 3-year progression-free survival (paraskeletal: P=0.86, and extramedullary organ: P=0.88). In single paraskeletal involvement, this translated less clearly into worse 3-year overall survival (P=0.07) while single organ involvement was significantly worse (P=0.001). Multiple organ sites were associated with worse outcome (P<0.001 and P=0.01). First-line treatment with tandem compared with single transplantation resulted in similar survival in patients with extramedullary disease at diagnosis (P=0.13 for both).

KW - Journal Article

U2 - 10.3324/haematol.2017.178434

DO - 10.3324/haematol.2017.178434

M3 - SCORING: Journal article

C2 - 29419433

VL - 103

SP - 890

EP - 897

JO - HAEMATOLOGICA

JF - HAEMATOLOGICA

SN - 0390-6078

IS - 5

ER -