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Clinical features and outcomes after auto-SCT in patients with multiple myeloma and renal impairment
Abstracts PO-131 Early progression (within 12 months) after autologous stem-cell transplantation in patients with multiple myeloma S.H. Lim, H.S. Kim, J.Y. Lee, K.H. Yoo, K.S. Jung, H.-N. Song, J. Cho, S. Park, S.J. Kim, J.H. Jang, W.S. Kim, C.W. Jung, K. Kim Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Background: Autologous stem cell transplantation (ASCT) has become the standard of care for eligible patients with newly diagnosed multiple myeloma (MM). Although, attaining best pre-transplant response is important for long-term disease control, early progressive disease after ASCT is not fully understood in a subset of MM patients. The aim of this study is was to evaluate risk factors and clinical features of patients with early progression of disease after ASCT. Methods: We retrospectively reviewed 330 patients diagnosed with MM based on the International Myeloma Working Group diagnostic criteria and underwent ASCT between October 1998 and February 2015. Patients who progressed within 12months after ASCT were classified as the study group. Univariate and multivariate analyses were performed on the recognized baseline parameters, and treatment related factors were also evaluated. Results: Among 324 patients, 103 (32%) progressed within 12 months after stem cell transplantation. Multivariate logistic regression analyses revealed that azotemia (Cr2.0mg/dL) (RR¼3.2) and non-hyperdiploidy (RR¼2.6) were independently associated with early progressive disease (P<0.05). During a median 2.8 years of follow-up, the median overall survival of patients who progressed within 12 months after ASCT was significant poor (29.1months, 95% CI, 22.3-35.9) compared to those who did not progress within 12 months (94.5months, 95% CI, 78.5-110.5, p < 0.001). Conclusions: Early progression of disease after ASCT is associated with a poor prognosis in MM patients. PreASCT response ( PR versus < PR) did not affect early disease progression after stem cell transplantation. Patients with nonhyperdiploidy and azotemia may experience a limited benefit from ASCT. Further tailored therapy is needed for these patients.
younger than 65 years old and reduced renal function, defined as serum creatinine (S-Cr) over 2 mg/dL or estimated glomerular filtration rate (eGFR using MDRD) <40 ml/min/m2, including those who were dialysis dependent at single center over a 15-year period (1996-2015). Results: A total of 56 patients underwent auto-SCT and 47 patients received conventional chemotherapy without auto-SCT. Median follow-up period was 19.25 months. Median GFR were 16.4 ml/min/1.73m2 (range, 2.4-39.0) and 15.0 ml/min/1.73m2 (range, 3.2-38.4), respectively. The transplantation related mortality was 5%. Both progression-free survival (PFS) and overall survival (OS) were significantly longer in auto-SCT group than with conventional chemotherapy (median PFS, 25.3 months vs. 4.6 months; p¼0.001 and median overall survival, 66.5 months vs. 9.2 months; p¼0.000). Multivariate analysis indicated that the auto-SCT was a significant prognostic factor for OS (hazard ratio 0.33; 95% confidence interval 0.19-0.59). Renal impairment stage 5, defined as GFR<15 ml/min/m2 or dialysis-dependent was also independent prognostic factors for OS. Conclusion: Auto-SCT is effective treatment in patients with myloma-related renal failure and successful implementation of auto-SCT requires well-coordinated supportive care.
PO-133 Stem Cell Mobilization and Autologous Stem Cell Transplantation after Pretreatment consisting of Bendamustine, Prednisone and Bortezomib (BPV) in 35 Patients with newly diagnosed/untreated Multiple Myeloma W. Poenisch, M. Plötze, B. Holzvogt, M. Andrea, T. Schliwa, T. Zehrfeld, D. Hammerschmidt, M. Schwarz, T. Edelmann, C. Becker, F.A. Hoffmann, A. Schwarzer, U. Kreibich, K. Gutsche, K. Reifenrath, W. Elsel, H. Schwarzbach, M. Bourgeois, S. Heyn, G.-N. Franke, M. Jentzsch, S. Leiblein, R. Krahl, S. Schwind, V. Vucinic, H.-K. AlAli, D. Niederwieser East German Study Group of Hematology and Oncology (OSHO) University of Leipzig, Department of Hematology
PO-132 Clinical features and outcomes after auto-SCT in patients with multiple myeloma and renal impairment Hyewon Ryu, S. Kim, K. Lee, C. Suh, D.H. Yoon Department of Oncology, Asan Medical Center
Background: Renal impairment is frequent in patients with multiple myeloma and is associated with reduced survival. Autologous stem cell transplantation (auto-SCT) is still a standard of care in young patients. However, it is not clear whether auto SCT can improve survival in patients with advanced renal failure. Patients and Methods: We conducted a retrospective study to investigate the significance of auto-SCT in myeloma patients
Introduction: Bendamustine is a bifunctional alkylating agent with low toxicity that produces both single- and double-strand breaks in DNA, and shows only partial cross resistance with other alkylating drugs. Treatment of patients with newly diagnosed multiple myeloma (MM) using Bendamustine and Prednisone in comparison to Melphalan and Prednisone results in superior complete response rate and prolonged time to treatment failure (Poenisch et al, Res Clin Oncol 132: 205-212;2006). So far, however, reliable information on stem cell toxicity and mobilization of stem cells for autologous stem cell transplantation (SCT) after induction treatment with a combination of bendamustine, prednisone and bortezomib (BPV) is missing. Material and Methods: A retrospective analysis of peripheral blood stem cell mobilization and autologous SCT was performed in 35 patients with MM who had
15th International Myeloma Workshop, September 23-26, 2015
- e157
Background: Autologous stem cell transplantation (ASCT) has become the standard of care for eligible patients with newly diagnosed multiple myeloma (MM). Although, attaining best pre-transplant response is important for long-term disease control, early progressive disease after ASCT is not fully understood in a subset of MM patients. The aim of this study is was to evaluate risk factors and clinical features of patients with early progression of disease after ASCT. Methods: We retrospectively reviewed 330 patients diagnosed with MM based on the International Myeloma Working Group diagnostic criteria and underwent ASCT between October 1998 and February 2015. Patients who progressed within 12months after ASCT were classified as the study group. Univariate and multivariate analyses were performed on the recognized baseline parameters, and treatment related factors were also evaluated. Results: Among 324 patients, 103 (32%) progressed within 12 months after stem cell transplantation. Multivariate logistic regression analyses revealed that azotemia (Cr2.0mg/dL) (RR¼3.2) and non-hyperdiploidy (RR¼2.6) were independently associated with early progressive disease (P<0.05). During a median 2.8 years of follow-up, the median overall survival of patients who progressed within 12 months after ASCT was significant poor (29.1months, 95% CI, 22.3-35.9) compared to those who did not progress within 12 months (94.5months, 95% CI, 78.5-110.5, p < 0.001). Conclusions: Early progression of disease after ASCT is associated with a poor prognosis in MM patients. PreASCT response ( PR versus < PR) did not affect early disease progression after stem cell transplantation. Patients with nonhyperdiploidy and azotemia may experience a limited benefit from ASCT. Further tailored therapy is needed for these patients.
younger than 65 years old and reduced renal function, defined as serum creatinine (S-Cr) over 2 mg/dL or estimated glomerular filtration rate (eGFR using MDRD) <40 ml/min/m2, including those who were dialysis dependent at single center over a 15-year period (1996-2015). Results: A total of 56 patients underwent auto-SCT and 47 patients received conventional chemotherapy without auto-SCT. Median follow-up period was 19.25 months. Median GFR were 16.4 ml/min/1.73m2 (range, 2.4-39.0) and 15.0 ml/min/1.73m2 (range, 3.2-38.4), respectively. The transplantation related mortality was 5%. Both progression-free survival (PFS) and overall survival (OS) were significantly longer in auto-SCT group than with conventional chemotherapy (median PFS, 25.3 months vs. 4.6 months; p¼0.001 and median overall survival, 66.5 months vs. 9.2 months; p¼0.000). Multivariate analysis indicated that the auto-SCT was a significant prognostic factor for OS (hazard ratio 0.33; 95% confidence interval 0.19-0.59). Renal impairment stage 5, defined as GFR<15 ml/min/m2 or dialysis-dependent was also independent prognostic factors for OS. Conclusion: Auto-SCT is effective treatment in patients with myloma-related renal failure and successful implementation of auto-SCT requires well-coordinated supportive care.
PO-133 Stem Cell Mobilization and Autologous Stem Cell Transplantation after Pretreatment consisting of Bendamustine, Prednisone and Bortezomib (BPV) in 35 Patients with newly diagnosed/untreated Multiple Myeloma W. Poenisch, M. Plötze, B. Holzvogt, M. Andrea, T. Schliwa, T. Zehrfeld, D. Hammerschmidt, M. Schwarz, T. Edelmann, C. Becker, F.A. Hoffmann, A. Schwarzer, U. Kreibich, K. Gutsche, K. Reifenrath, W. Elsel, H. Schwarzbach, M. Bourgeois, S. Heyn, G.-N. Franke, M. Jentzsch, S. Leiblein, R. Krahl, S. Schwind, V. Vucinic, H.-K. AlAli, D. Niederwieser East German Study Group of Hematology and Oncology (OSHO) University of Leipzig, Department of Hematology
PO-132 Clinical features and outcomes after auto-SCT in patients with multiple myeloma and renal impairment Hyewon Ryu, S. Kim, K. Lee, C. Suh, D.H. Yoon Department of Oncology, Asan Medical Center
Background: Renal impairment is frequent in patients with multiple myeloma and is associated with reduced survival. Autologous stem cell transplantation (auto-SCT) is still a standard of care in young patients. However, it is not clear whether auto SCT can improve survival in patients with advanced renal failure. Patients and Methods: We conducted a retrospective study to investigate the significance of auto-SCT in myeloma patients
Introduction: Bendamustine is a bifunctional alkylating agent with low toxicity that produces both single- and double-strand breaks in DNA, and shows only partial cross resistance with other alkylating drugs. Treatment of patients with newly diagnosed multiple myeloma (MM) using Bendamustine and Prednisone in comparison to Melphalan and Prednisone results in superior complete response rate and prolonged time to treatment failure (Poenisch et al, Res Clin Oncol 132: 205-212;2006). So far, however, reliable information on stem cell toxicity and mobilization of stem cells for autologous stem cell transplantation (SCT) after induction treatment with a combination of bendamustine, prednisone and bortezomib (BPV) is missing. Material and Methods: A retrospective analysis of peripheral blood stem cell mobilization and autologous SCT was performed in 35 patients with MM who had
15th International Myeloma Workshop, September 23-26, 2015
- e157