Continued Improvement in Survival of Multiple Myeloma Patients: An Institutional Study from 1992-2016

Abstract

Introduction Multiple myeloma (MM) represents 1.8% of all new cancer cases in the U.S. While not curable, advances in treatment, including autologous stem cell transplant (ASCT) and maintenance therapy, have dramatically improved progression free survival (PFS) and overall survival (OS). The Ohio State University began utilizing ASCT for newly diagnosed MM (NDMM) patients in 1992. With the introduction of new, more effective drugs used before and after ASCT over time, we performed retrospective survival analysis in NDMM patients receiving ASCT from 1992-2016. Method Consecutive 1002 NDMM patients were eligible. Patients were split into five groups based on historic changes in novel agents for treatment of MM: 1992-1998-group 1, 1999-2002-group 2, 2003-2008-group 3, 2009-2013-group 4, and 2014-2016-group 5. Pre-ASCT conditioning regimen was melphalan, 140 or 200 mg/m2. High-risk patients had del17, t(4:14), t(14:16), and/or 1q abnormality. Primary endpoints were PFS and OS. Kaplan Meier curves were used to calculate PFS and OS. Results Across the years (1992-2016), there was a statistically significant improvement in both PFS (p 65 years old, there was a statistically significant improvement in PFS (p Conclusion Survival since 1992 have improved primarily due to inclusion of novel therapies and maintenance. For NDMM patients receiving ASCT, the 3 year overall survival rate has significantly improved from 45% in 1992-1998 to 80% in 2014-2016, which is similar to the post-ASCT OS shown in the 2012 study by McCarthy et al. The significantly increasing age of NDMM patients receiving ASCT over time suggests improvement in supportive care and tolerability of current therapies.