A Response Adapted Approach to Induction Treatment Yields acceptable Outcome in Patients with Multiple Myeloma (MM) undergoing Autologous Stem Cell transplantation (ASCT)

Abstract

mo (range 2.9-178.1) for the 190 survivors. Median age was 58. 61% were male. 38% had ISS stage I and 18% stage III. 10% had high risk cytogenetics. 51% started therapy using 1⁄4 3-druginduction-regimens. There appeared to be no statistically significant difference in age, cytogenetic risk, and ISS between pts in both groups (p1⁄40.128, 0.362, 0.302, respectively) but time from induction to ASCT was statistically different (6.1 vs 6.5 mo, p1⁄40.012). Best response prior to ASCT was >1⁄4VGPR 52% and >1⁄4PR 88% while post ASCT >1⁄4VGPR 82% and >1⁄4PR 98%. Median PFS from ASCT for the entire cohort was 32.3 mo, and median OS 84.2 mo. By multivariate analysis, cytogenetic risk (p1⁄40.002) and response prior to ASCT (p 1⁄43 groups, we could not show a statistical difference in median PFS (29.5 mo vs 33.4 mo; p1⁄40.26) and OS (78.6 mo vs 94.4 mo; p1⁄40.54), respectively. Conclusion: This retrospective study suggests that a response adapted approach to MM therapy may yield good outcome and guide the choice of induction. With emerging data suggesting the importance of MRD in predicting outcome, response-driven study designs should be prospectively explored.