Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A CMWP-EBMT study
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Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A CMWP-EBMT study. / Gagelmann, Nico; Eikema, Dirk-Jan; Koster, Linda; Netelenbos, Tanja; McDonald, Andrew; Stoppa, Anne-Marie; Fenk, Roland; Anagnostopoulos, Achilles; van Gorkom, Gwendolyn; Deconinck, Eric; Bulabois, Claude-Eric; Delforge, Michel; Bunjes, Donald; Arcese, William; Reményi, Péter; Itälä-Remes, Maija; Thurner, Lorenz; Bolaman, Ali Zahit; Nabil, Yafour; Lund, Johan; Labussière-Wallet, Hélène; Hayden, Patrick J; Beksac, Meral; Schönland, Stefan; Yakoub-Agha, Ibrahim.
in: EUR J HAEMATOL, Jahrgang 111, Nr. 2, 08.2023, S. 181-190.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A CMWP-EBMT study
AU - Gagelmann, Nico
AU - Eikema, Dirk-Jan
AU - Koster, Linda
AU - Netelenbos, Tanja
AU - McDonald, Andrew
AU - Stoppa, Anne-Marie
AU - Fenk, Roland
AU - Anagnostopoulos, Achilles
AU - van Gorkom, Gwendolyn
AU - Deconinck, Eric
AU - Bulabois, Claude-Eric
AU - Delforge, Michel
AU - Bunjes, Donald
AU - Arcese, William
AU - Reményi, Péter
AU - Itälä-Remes, Maija
AU - Thurner, Lorenz
AU - Bolaman, Ali Zahit
AU - Nabil, Yafour
AU - Lund, Johan
AU - Labussière-Wallet, Hélène
AU - Hayden, Patrick J
AU - Beksac, Meral
AU - Schönland, Stefan
AU - Yakoub-Agha, Ibrahim
N1 - © 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.
PY - 2023/8
Y1 - 2023/8
N2 - BACKGROUND: No adequate data exist on the impact of multiple myeloma (MM) with extramedullary disease (EMD) after autograft and maintenance therapy.METHODS: We identified 808 patients with newly diagnosed MM who received first autograft, of whom 107 had EMD (83 paraskeletal and 24 organ involvement), and who had been reported to the EBMT registry December 2018. Distribution according to type of involvement was similar between the treatment groups (p = .69). For EMD, 46 (40%) received thalidomide, 59 (51%) lenalidomide, and 11 (10%) bortezomib.RESULTS: The median follow-up from maintenance start was 44 months. Three-year progression-free survival (PFS) was 52% (48%-57%) for no EMD, 56% (44%-69%) for paraskeletal involvement, and 45% (22%-68%) for organ involvement (p = .146). Early PFS (within first year) appeared to be significantly worse for organ involvement (hazard ratio, 3.40), while no significant influence was found after first year from maintenance start. Three-year overall survival (OS) was 81% (77%-84%), 88% (80%-96%), and 68% (47%-89%; p = .064), respectively. With thalidomide as reference, lenalidomide was significantly associated with better PFS and OS, whereas bortezomib appeared to improve outcome specifically in EMD.CONCLUSION: Lenalidomide maintenance is standard of care for MM without EMD, whereas extramedullary organ involvement remains a significant risk factor for worse outcome, especially for early events after maintenance start.
AB - BACKGROUND: No adequate data exist on the impact of multiple myeloma (MM) with extramedullary disease (EMD) after autograft and maintenance therapy.METHODS: We identified 808 patients with newly diagnosed MM who received first autograft, of whom 107 had EMD (83 paraskeletal and 24 organ involvement), and who had been reported to the EBMT registry December 2018. Distribution according to type of involvement was similar between the treatment groups (p = .69). For EMD, 46 (40%) received thalidomide, 59 (51%) lenalidomide, and 11 (10%) bortezomib.RESULTS: The median follow-up from maintenance start was 44 months. Three-year progression-free survival (PFS) was 52% (48%-57%) for no EMD, 56% (44%-69%) for paraskeletal involvement, and 45% (22%-68%) for organ involvement (p = .146). Early PFS (within first year) appeared to be significantly worse for organ involvement (hazard ratio, 3.40), while no significant influence was found after first year from maintenance start. Three-year overall survival (OS) was 81% (77%-84%), 88% (80%-96%), and 68% (47%-89%; p = .064), respectively. With thalidomide as reference, lenalidomide was significantly associated with better PFS and OS, whereas bortezomib appeared to improve outcome specifically in EMD.CONCLUSION: Lenalidomide maintenance is standard of care for MM without EMD, whereas extramedullary organ involvement remains a significant risk factor for worse outcome, especially for early events after maintenance start.
KW - Humans
KW - Multiple Myeloma/therapy
KW - Bortezomib/therapeutic use
KW - Lenalidomide/therapeutic use
KW - Thalidomide/therapeutic use
KW - Autografts
KW - Transplantation, Autologous
KW - Antineoplastic Combined Chemotherapy Protocols/adverse effects
KW - Dexamethasone/therapeutic use
U2 - 10.1111/ejh.13981
DO - 10.1111/ejh.13981
M3 - SCORING: Journal article
C2 - 37082839
VL - 111
SP - 181
EP - 190
JO - EUR J HAEMATOL
JF - EUR J HAEMATOL
SN - 0902-4441
IS - 2
ER -