Prolonged survival after second autologous transplantation and lenalidomide maintenance for salvage treatment of myeloma patients at first relapse after prior autograft.

Gössi, Ursina; Jeker, Barbara; Mansouri Taleghani, Behrouz; Bacher, Vera Ulrike; Novak, Urban; Betticher, Daniel; Egger, Thomas; Zander, Thilo; Pabst, Thomas (2018). Prolonged survival after second autologous transplantation and lenalidomide maintenance for salvage treatment of myeloma patients at first relapse after prior autograft. Hematological oncology, 36(2), pp. 436-444. Wiley 10.1002/hon.2490

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Autologous stem cell transplantation (ASCT) as part of the primary therapy in multiple myeloma (MM) is standard practice. In contrast, the role of a second ASCT (ASCT2) and subsequent lenalidomide maintenance for relapsed disease remains unclear. In this study, we analysed 86 consecutive MM patients with a first relapse after prior ASCT receiving either a second ASCT or conventional chemotherapy. After a median follow-up of 37.7 months since first relapse, 54 (62.8%) patients were still alive and 29 (33.7%) without progression. Sixty-one (71.0%) patients received ASCT2 and had better progression-free survival (PFS) (30.2 versus 13.0 mo; P = .0262) and overall survival (OS) rates (129.6 versus 33.5 mo; P = .0003) compared with 25 (29.0%) patients with conventional treatment. Patients relapsing later than 12 months after ASCT1 benefitted from a second ASCT with better PFS2 (P = .0179) and OS2 (P = .0009). Finally, lenalidomide maintenance after ASCT2 was associated with longer PFS (41.0 vs 21.6 mo; P = .0034) and better OS (not yet reached vs 129.6 mo; P = .0434) compared with patients without maintenance. Our data suggest that a second ASCT and lenalidomide maintenance given at first relapse in MM after prior ASCT are associated with better survival rates.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Jeker, Barbara; Mansouri Taleghani, Behrouz; Bacher, Vera Ulrike; Novak, Urban and Pabst, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1099-1069

Publisher:

Wiley

Language:

English

Submitter:

Nicole Corminboeuf

Date Deposited:

16 Apr 2018 14:55

Last Modified:

03 Nov 2019 12:04

Publisher DOI:

10.1002/hon.2490

PubMed ID:

29363149

Uncontrolled Keywords:

autologous chemotherapy high-dose lenalidomide maintenance myeloma relapse salvage stem cell survival transplant

BORIS DOI:

10.7892/boris.111445

URI:

https://boris.unibe.ch/id/eprint/111445

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