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      Outcome of Autologous Hematopoietic Stem Cell Transplantation in Refractory Multiple Myeloma

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          Abstract

          Background

          Despite the introduction of effective novel agents, the outcome of patients with refractory multiple myeloma remains poor, particularly those refractory to both proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs). Limited data is available on the role of autologous hematopoietic stem cell transplantation in this population.

          Methods

          We retrospectively analyzed refractory myeloma patients who underwent first auto-HCT between March 2000 and October 2015. Patients with primary refractory disease and those with relapsed and refractory disease were included. Patients with disease refractory to at least one PI and at least one IMiD were classified as double refractory (DR-MM).

          Results

          233 patients were identified: 105 (45%) had DR-MM while the remaining 128 (55%) patients were classified as non-double refractory (NDR-MM). With median follow up of 42 months for surviving patients, at least partial response was seen in 188 (81%) patients (DR-MM, 83 [79%]; NDR-MM, 105 [82%]; p=0.77). Near complete remission or better was seen in 52 (22%) patients (DR-MM, 25 [24%]; NDR-MM, 27 [21%]; p=0.77). The median progression-free survival (PFS) was 17.6 months (14.4 months in the DR-MM patients and 18.2 months in the NDR-MM patients) and the 2-year PFS rate was 38% (DR-MM, 35%; NDR-MM, 40%; p=0.40). Median overall survival (OS) was 48.0 months (38.9 months in DR-MM and 56.6 months in NDR-MM) and the 2-year OS rate was 74% (DR-MM, 71%; NDR-MM, 76%; p=0.27).

          Conclusions

          Our findings highlight that auto-HCT is an effective and safe therapy in patients with refractory multiple myeloma including those refractory to an IMiD and PI.

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          Author and article information

          Journal
          0374236
          2771
          Cancer
          Cancer
          Cancer
          0008-543X
          1097-0142
          6 May 2017
          17 May 2017
          15 September 2017
          15 September 2018
          : 123
          : 18
          : 3568-3575
          Affiliations
          [1 ]Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson, Texas
          [2 ]Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
          [3 ]Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
          Author notes
          Corresponding Author: Qaiser Bashir, MD, Associate Professor, Department of Stem Cell Transplantation & Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX 77030, Phone: 713-794-5745, Fax: 713-794-4902, qbashir@ 123456mdanderson.org
          Article
          PMC5656242 PMC5656242 5656242 nihpa870728
          10.1002/cncr.30770
          5656242
          28513828
          Categories
          Article

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