Autologous stem cell transplantation in multiple myeloma: Post-transplant outcomes of Taiwan Blood and Marrow Transplantation Registry.


Journal

Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN: 0929-6646
Titre abrégé: J Formos Med Assoc
Pays: Singapore
ID NLM: 9214933

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 07 11 2017
revised: 01 06 2018
accepted: 26 07 2018
pubmed: 19 8 2018
medline: 13 3 2019
entrez: 19 8 2018
Statut: ppublish

Résumé

Multiple myeloma (MM) is a monoclonal plasma cell malignancy. The primary choice of treatment for MM is induction therapy followed by autologous stem cell transplantation (ASCT). This study aimed to analyze the treatment efficacy of ASCT in a Taiwanese cohort and evaluate possible prognostic factors. From the database of the Taiwan Blood and Marrow Transplantation registry, data on 396 patients with MM who underwent ASCT were reviewed. The average age of participants was 54.8 years, and there were more men than women (57.6% vs. 42.4%). Most patients were diagnosed with IgG-type myeloma (52.4%), followed by IgA-type (23.2%) and light-chain type (21.4%). Patients with Durie Salmon Staging System (DSS) III disease accounted for 61.9% of the study cohort, while 23.7% had stage II and 14.4% had stage I disease. The median progression-free survival (PFS) and overall survival (OS) after ASCT were 46.5 months and 70.4 months, respectively. DSS III was a poor prognostic factor affecting both PFS and OS with a duration of 35.9 months and 69.0 months, respectively, compared with the other two stages (p = 0.006 and p = 0.03, respectively). In addition, patients with better treatment response before ASCT had better PFS and OS compared with those who did not show a response (both p < 0.0001). The overall incidence of organ toxicities associated with transplantation was low. In conclusion, our cohort showed that myeloma patients with early DSS and better treatment response before ASCT had better long-term survival outcomes.

Sections du résumé

BACKGROUND/PURPOSE OBJECTIVE
Multiple myeloma (MM) is a monoclonal plasma cell malignancy. The primary choice of treatment for MM is induction therapy followed by autologous stem cell transplantation (ASCT). This study aimed to analyze the treatment efficacy of ASCT in a Taiwanese cohort and evaluate possible prognostic factors.
METHODS METHODS
From the database of the Taiwan Blood and Marrow Transplantation registry, data on 396 patients with MM who underwent ASCT were reviewed.
RESULTS RESULTS
The average age of participants was 54.8 years, and there were more men than women (57.6% vs. 42.4%). Most patients were diagnosed with IgG-type myeloma (52.4%), followed by IgA-type (23.2%) and light-chain type (21.4%). Patients with Durie Salmon Staging System (DSS) III disease accounted for 61.9% of the study cohort, while 23.7% had stage II and 14.4% had stage I disease. The median progression-free survival (PFS) and overall survival (OS) after ASCT were 46.5 months and 70.4 months, respectively. DSS III was a poor prognostic factor affecting both PFS and OS with a duration of 35.9 months and 69.0 months, respectively, compared with the other two stages (p = 0.006 and p = 0.03, respectively). In addition, patients with better treatment response before ASCT had better PFS and OS compared with those who did not show a response (both p < 0.0001). The overall incidence of organ toxicities associated with transplantation was low.
CONCLUSION CONCLUSIONS
In conclusion, our cohort showed that myeloma patients with early DSS and better treatment response before ASCT had better long-term survival outcomes.

Identifiants

pubmed: 30119948
pii: S0929-6646(17)30811-2
doi: 10.1016/j.jfma.2018.07.020
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

471-480

Informations de copyright

Copyright © 2018. Published by Elsevier B.V.

Auteurs

Tzu-Chuan Huang (TC)

Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Shang-Yi Huang (SY)

Hematology-Oncology Section, National Taiwan University Hospital, Taipei, Taiwan.

Ming Yao (M)

Hematology-Oncology Section, National Taiwan University Hospital, Taipei, Taiwan.

Chen-Yuan Lin (CY)

Division of Hematology and Oncology, Department of Medicine, China Medical University Hospital, Taiwan.

Wen-Li Hwang (WL)

Division of Hematology/Medical Oncology, Taichung Veterans General Hospital, Taiwan.

Jyh-Pyng Gau (JP)

Division of Hematology, Taipei Veterans General Hospital, National Yang-Ming University, Taiwan.

Tran-Der Tan (TD)

Department of Hematology and Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taiwan.

Po-Nan Wang (PN)

Division of Hematology, Chang Gung Medical Foundation, Linkou Branch, Taiwan.

Yi-Chang Liu (YC)

Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Shih-Chiang Lin (SC)

Division of Oncology-Hematology, Far Eastern Memorial Hospital, Taiwan.

Ruey-Ho Kao (RH)

Department of Hematology and Oncology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.

Sung-Nan Pei (SN)

Kaohsiung Chang-Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Ming-Sun Yu (MS)

Hematology/Oncology Division, Dept. of Medicine Veterans General Hospital, Kaohsiung, Taiwan.

Hsuan-Yu Lin (HY)

Changhua Christian Hospital, Internal Medicine Department, Hematology and Oncology Division, Taiwan.

Yung-Cheng Su (YC)

Division of Hemato-Oncology, Taipei Medical University-Shuang Ho Hospital, Taiwan.

Chih-Cheng Chen (CC)

Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.

Sin-Syue Li (SS)

Division of Hematology/Oncology, National Cheng Kung University Hospital, Tainan, Taiwan.

Yi-Ying Wu (YY)

Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: rq0922@gmail.com.

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