학술논문
In the era of Bortezomib-based Induction, intensification of Melphalan-based conditioning with Bortezomib does not improve Survival Outcomes in newly diagnosed Multiple Myeloma: a study from the Chronic Malignancies Working Party of the EBMT
Document Type
Article
Author
Beksac, Meral; Eikema, Diderik-Jan; Koster, Linda; Hulin, Cyrille; Poiré, Xavier; Hamladji, Rose-Marie; Gromek, Tomasz; Bazarbachi, Ali; Ozkurt, Zubeyde Nur; Pabst, Thomas; Ben Othman, Tarek; Finke, Jürgen; Pirogova, Olga; Wu, Depei; Hayat, Amjad; Hilgendorf, Inken; Tholouli, Eleni; de Wreede, Liesbeth C.; Schönland, Stefan; Garderet, Laurent; Drozd-Sokolowska, Joanna; Raj, Kavita; Hayden, Patrick J.; Yakoub-Agha, Ibrahim; McLornan, Donal P.
Source
Bone Marrow Transplantation; 20240101, Issue: Preprints p1-8, 8p
Subject
Language
ISSN
02683369; 14765365
Abstract
Bortezomib (Vel)- Melphalan 200 mg/m2 (Mel200) (Vel-Mel) has been utilised to intensify conditioning in autologous hematopoietic stem cell transplantation (AHCT) for multiple myeloma (MM). This EBMT registry-based study compared Vel-Mel with Mel200 during upfront AHCT. Between 2010 and 2017, MM patients who received Vel-Mel (n = 292) conditioning were compared with 4,096 Mel200 patients in the same 58 centres. Pre-AHCT, compared to Mel200 patients, Vel-Mel patients had similar International Staging System (ISS) scores and cytogenetic risk profiles; a similar proportion had received bortezomib-based induction (85% and 87.3%, respectively) though they were younger with a better performance status. Vel-Mel patients were more likely to achieve CR post-induction (40.6% vs 20.3%, p < 0.001) and by day 100 of AHCT (CR/VGPR: 70.2 % vs. 57.2%, p < 0.001). There was no difference in 3-year PFS (49% vs 46%, p = 0.06) or early post-AHCT mortality. In multivariable analysis, Vel-Mel associated with inferior PFS (HR: 1.69 (1.27–2.25, p < 0.001) and OS (HR:1.46 (1.14–1.86,p = 0.002), similar to negative effects on PFS of advanced ISS (HR:1.56 (1.33–1.83, p < 0.001), high-risk cytogenetics (HR:1.43(1.18–1.74, p < 0.001) and poor post-induction response(<=PR)(HR: 1.43(1.25–1.62, p < 0.001) Overall, despite superior pre- and post-AHCT responses, there was no improvement in PFS or OS following Vel-Mel. This data supports the findings of the smaller prospective IFM study.