Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation

Nico Gagelmann; Diderik-Jan Eikema; Linda Koster; Denis Caillot; Pietro Pioltelli; Juan Bargay Lleonart; Péter Reményi; Didier Blaise; Nicolaas Schaap; Marek Trneny; Jakob Passweg; Rocio Parody Porras; Jean Yves Cahn; Maurizio Musso; Xavier Poiré; Roland Fenk; Maija Itälä-Remes; Vincenzo Pavone; Loic Fouillard; Johan Maertens; Dominique Bron; Anastasia Pouli; Wilfried Schroyens; Stefan Schönland; Laurent Garderet; Ibrahim Yakoub-Agha; Nicolaus Kröger

doi:10.1016/j.bbmt.2019.07.004

Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation

Standard

Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. / Gagelmann, Nico; Eikema, Diderik-Jan; Koster, Linda; Caillot, Denis; Pioltelli, Pietro; Lleonart, Juan Bargay; Reményi, Péter; Blaise, Didier; Schaap, Nicolaas; Trneny, Marek; Passweg, Jakob; Porras, Rocio Parody; Cahn, Jean Yves; Musso, Maurizio; Poiré, Xavier; Fenk, Roland; Itälä-Remes, Maija; Pavone, Vincenzo; Fouillard, Loic; Maertens, Johan; Bron, Dominique; Pouli, Anastasia; Schroyens, Wilfried; Schönland, Stefan; Garderet, Laurent; Yakoub-Agha, Ibrahim; Kröger, Nicolaus.

in: BIOL BLOOD MARROW TR, Jahrgang 25, Nr. 11, 11.2019, S. 2134-2142.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Gagelmann, N, Eikema, D-J, Koster, L, Caillot, D, Pioltelli, P, Lleonart, JB, Reményi, P, Blaise, D, Schaap, N, Trneny, M, Passweg, J, Porras, RP, Cahn, JY, Musso, M, Poiré, X, Fenk, R, Itälä-Remes, M, Pavone, V, Fouillard, L, Maertens, J, Bron, D, Pouli, A, Schroyens, W, Schönland, S, Garderet, L, Yakoub-Agha, I & Kröger, N 2019, 'Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation', BIOL BLOOD MARROW TR, Jg. 25, Nr. 11, S. 2134-2142. https://doi.org/10.1016/j.bbmt.2019.07.004

APA

Gagelmann, N., Eikema, D-J., Koster, L., Caillot, D., Pioltelli, P., Lleonart, J. B., Reményi, P., Blaise, D., Schaap, N., Trneny, M., Passweg, J., Porras, R. P., Cahn, J. Y., Musso, M., Poiré, X., Fenk, R., Itälä-Remes, M., Pavone, V., Fouillard, L., ... Kröger, N. (2019). Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. BIOL BLOOD MARROW TR, 25(11), 2134-2142. https://doi.org/10.1016/j.bbmt.2019.07.004

Vancouver

Gagelmann N, Eikema D-J, Koster L, Caillot D, Pioltelli P, Lleonart JB et al. Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. BIOL BLOOD MARROW TR. 2019 Nov;25(11):2134-2142. https://doi.org/10.1016/j.bbmt.2019.07.004

Bibtex

@article{091eeda22cf24f448aaba1419064113d,

title = "Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation",

abstract = "Although high-dose therapy and autologous stem cell transplant combined with novel agents continues to be the hallmark of first-line treatment in newly diagnosed transplant-eligible multiple myeloma patients, the impact of tandem autologous or autologous/reduced-intensity allogeneic transplant for patients with extramedullary disease (EMD) and high-risk cytogenetics is not yet defined. Here, we analyzed clinical and cytogenetic data from 488 adult myeloma patients with EMD undergoing single autologous (n = 373), tandem autologous (n = 84), or autologous-allogeneic transplant (n = 31) between 2003 and 2015. At least 1 high-risk abnormality was present in 41% (n = 202), with del(17p) (40%) and t(4;14) (45%) the most frequent. More than 1 high-risk abnormality was found in 54%. High-risk cytogenetics showed worse 4-year overall survival (OS) and progression-free survival (PFS) of 54% and 29%, respectively, versus 78% and 49% for standard-risk cytogenetics (P < .001). Co-segregation of high-risk abnormalities did not seem to affect outcome. Regarding transplant regimen, OS and PFS were 70% and 43% for single autologous versus 83% and 52% for tandem autologous and 88% and 58% for autologous-allogeneic (P = .06 and P = .30). In multivariate analysis high-risk cytogenetics were associated with worse survival (hazard ratio [HR], 2.00; P = .003), whereas tandem autologous significantly improved outcome versus single autologous transplant (HRs, .46 and .64; P = .02 and P = .03). Autologous-allogeneic transplant did not significantly differ in outcome but appeared to improve survival, but results were limited because of small population (HR, .31). In conclusion, high-risk cytogenetics is frequently observed in newly diagnosed myeloma with EMD and significantly worsens outcome after single autologous, whereas a tandem autologous transplant strategy may overcome onset poor prognosis.",

author = "Nico Gagelmann and Diderik-Jan Eikema and Linda Koster and Denis Caillot and Pietro Pioltelli and Lleonart, {Juan Bargay} and P{\'e}ter Rem{\'e}nyi and Didier Blaise and Nicolaas Schaap and Marek Trneny and Jakob Passweg and Porras, {Rocio Parody} and Cahn, {Jean Yves} and Maurizio Musso and Xavier Poir{\'e} and Roland Fenk and Maija It{\"a}l{\"a}-Remes and Vincenzo Pavone and Loic Fouillard and Johan Maertens and Dominique Bron and Anastasia Pouli and Wilfried Schroyens and Stefan Sch{\"o}nland and Laurent Garderet and Ibrahim Yakoub-Agha and Nicolaus Kr{\"o}ger",

year = "2019",

month = nov,

doi = "10.1016/j.bbmt.2019.07.004",

language = "English",

volume = "25",

pages = "2134--2142",

journal = "BIOL BLOOD MARROW TR",

issn = "1083-8791",

publisher = "Elsevier Inc.",

number = "11",

}

RIS

TY - JOUR

T1 - Tandem Autologous Stem Cell Transplantation Improves Outcomes in Newly Diagnosed Multiple Myeloma with Extramedullary Disease and High-Risk Cytogenetics: A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation

AU - Gagelmann, Nico

AU - Eikema, Diderik-Jan

AU - Koster, Linda

AU - Caillot, Denis

AU - Pioltelli, Pietro

AU - Lleonart, Juan Bargay

AU - Reményi, Péter

AU - Blaise, Didier

AU - Schaap, Nicolaas

AU - Trneny, Marek

AU - Passweg, Jakob

AU - Porras, Rocio Parody

AU - Cahn, Jean Yves

AU - Musso, Maurizio

AU - Poiré, Xavier

AU - Fenk, Roland

AU - Itälä-Remes, Maija

AU - Pavone, Vincenzo

AU - Fouillard, Loic

AU - Maertens, Johan

AU - Bron, Dominique

AU - Pouli, Anastasia

AU - Schroyens, Wilfried

AU - Schönland, Stefan

AU - Garderet, Laurent

AU - Yakoub-Agha, Ibrahim

AU - Kröger, Nicolaus

PY - 2019/11

Y1 - 2019/11

N2 - Although high-dose therapy and autologous stem cell transplant combined with novel agents continues to be the hallmark of first-line treatment in newly diagnosed transplant-eligible multiple myeloma patients, the impact of tandem autologous or autologous/reduced-intensity allogeneic transplant for patients with extramedullary disease (EMD) and high-risk cytogenetics is not yet defined. Here, we analyzed clinical and cytogenetic data from 488 adult myeloma patients with EMD undergoing single autologous (n = 373), tandem autologous (n = 84), or autologous-allogeneic transplant (n = 31) between 2003 and 2015. At least 1 high-risk abnormality was present in 41% (n = 202), with del(17p) (40%) and t(4;14) (45%) the most frequent. More than 1 high-risk abnormality was found in 54%. High-risk cytogenetics showed worse 4-year overall survival (OS) and progression-free survival (PFS) of 54% and 29%, respectively, versus 78% and 49% for standard-risk cytogenetics (P < .001). Co-segregation of high-risk abnormalities did not seem to affect outcome. Regarding transplant regimen, OS and PFS were 70% and 43% for single autologous versus 83% and 52% for tandem autologous and 88% and 58% for autologous-allogeneic (P = .06 and P = .30). In multivariate analysis high-risk cytogenetics were associated with worse survival (hazard ratio [HR], 2.00; P = .003), whereas tandem autologous significantly improved outcome versus single autologous transplant (HRs, .46 and .64; P = .02 and P = .03). Autologous-allogeneic transplant did not significantly differ in outcome but appeared to improve survival, but results were limited because of small population (HR, .31). In conclusion, high-risk cytogenetics is frequently observed in newly diagnosed myeloma with EMD and significantly worsens outcome after single autologous, whereas a tandem autologous transplant strategy may overcome onset poor prognosis.

AB - Although high-dose therapy and autologous stem cell transplant combined with novel agents continues to be the hallmark of first-line treatment in newly diagnosed transplant-eligible multiple myeloma patients, the impact of tandem autologous or autologous/reduced-intensity allogeneic transplant for patients with extramedullary disease (EMD) and high-risk cytogenetics is not yet defined. Here, we analyzed clinical and cytogenetic data from 488 adult myeloma patients with EMD undergoing single autologous (n = 373), tandem autologous (n = 84), or autologous-allogeneic transplant (n = 31) between 2003 and 2015. At least 1 high-risk abnormality was present in 41% (n = 202), with del(17p) (40%) and t(4;14) (45%) the most frequent. More than 1 high-risk abnormality was found in 54%. High-risk cytogenetics showed worse 4-year overall survival (OS) and progression-free survival (PFS) of 54% and 29%, respectively, versus 78% and 49% for standard-risk cytogenetics (P < .001). Co-segregation of high-risk abnormalities did not seem to affect outcome. Regarding transplant regimen, OS and PFS were 70% and 43% for single autologous versus 83% and 52% for tandem autologous and 88% and 58% for autologous-allogeneic (P = .06 and P = .30). In multivariate analysis high-risk cytogenetics were associated with worse survival (hazard ratio [HR], 2.00; P = .003), whereas tandem autologous significantly improved outcome versus single autologous transplant (HRs, .46 and .64; P = .02 and P = .03). Autologous-allogeneic transplant did not significantly differ in outcome but appeared to improve survival, but results were limited because of small population (HR, .31). In conclusion, high-risk cytogenetics is frequently observed in newly diagnosed myeloma with EMD and significantly worsens outcome after single autologous, whereas a tandem autologous transplant strategy may overcome onset poor prognosis.

U2 - 10.1016/j.bbmt.2019.07.004

DO - 10.1016/j.bbmt.2019.07.004

M3 - SCORING: Journal article

C2 - 31288095

VL - 25

SP - 2134

EP - 2142

JO - BIOL BLOOD MARROW TR

JF - BIOL BLOOD MARROW TR

SN - 1083-8791

IS - 11

ER -