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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, Vol. 111, No. 2, 08.2023, p. 181-190.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Gagelmann, N, Eikema, D-J, Koster, L, Netelenbos, T, McDonald, A, Stoppa, A-M, Fenk, R, Anagnostopoulos, A, van Gorkom, G, Deconinck, E, Bulabois, C-E, Delforge, M, Bunjes, D, Arcese, W, Reményi, P, Itälä-Remes, M, Thurner, L, Bolaman, AZ, Nabil, Y, Lund, J, Labussière-Wallet, H, Hayden, PJ, Beksac, M, Schönland, S & Yakoub-Agha, I 2023, 'Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A CMWP-EBMT study', EUR J HAEMATOL, vol. 111, no. 2, pp. 181-190. https://doi.org/10.1111/ejh.13981

APA

Gagelmann, N., Eikema, D-J., Koster, L., Netelenbos, T., McDonald, A., Stoppa, A-M., Fenk, R., Anagnostopoulos, A., van Gorkom, G., Deconinck, E., Bulabois, C-E., Delforge, M., Bunjes, D., Arcese, W., Reményi, P., Itälä-Remes, M., Thurner, L., Bolaman, A. Z., Nabil, Y., ... Yakoub-Agha, I. (2023). Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A CMWP-EBMT study. EUR J HAEMATOL, 111(2), 181-190. https://doi.org/10.1111/ejh.13981

Vancouver

Gagelmann N, Eikema D-J, Koster L, Netelenbos T, McDonald A, Stoppa A-M et al. Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A CMWP-EBMT study. EUR J HAEMATOL. 2023 Aug;111(2):181-190. https://doi.org/10.1111/ejh.13981

Bibtex

@article{3a10416b8d6a4abda36b0199a5998add,
title = "Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A CMWP-EBMT study",
abstract = "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.",
keywords = "Humans, Multiple Myeloma/therapy, Bortezomib/therapeutic use, Lenalidomide/therapeutic use, Thalidomide/therapeutic use, Autografts, Transplantation, Autologous, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Dexamethasone/therapeutic use",
author = "Nico Gagelmann and Dirk-Jan Eikema and Linda Koster and Tanja Netelenbos and Andrew McDonald and Anne-Marie Stoppa and Roland Fenk and Achilles Anagnostopoulos and {van Gorkom}, Gwendolyn and Eric Deconinck and Claude-Eric Bulabois and Michel Delforge and Donald Bunjes and William Arcese and P{\'e}ter Rem{\'e}nyi and Maija It{\"a}l{\"a}-Remes and Lorenz Thurner and Bolaman, {Ali Zahit} and Yafour Nabil and Johan Lund and H{\'e}l{\`e}ne Labussi{\`e}re-Wallet and Hayden, {Patrick J} and Meral Beksac and Stefan Sch{\"o}nland and Ibrahim Yakoub-Agha",
note = "{\textcopyright} 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.",
year = "2023",
month = aug,
doi = "10.1111/ejh.13981",
language = "English",
volume = "111",
pages = "181--190",
journal = "EUR J HAEMATOL",
issn = "0902-4441",
publisher = "Wiley-Blackwell",
number = "2",

}

RIS

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 -