Changing trends in prognostic factors for patients with multiple myeloma after autologous stem cell transplantation during the immunomodulator drug/proteasome inhibitor era

Cancer Science

Hiroyuki Takamatsu⁴  Sumihisa Honda¹¹  Toshihiro Miyamoto⁸  Kenji Yokoyama⁵  Shotaro Hagiwara³  Toshiro Ito⁹  Naoto Tomita⁶  Shinsuke Iida¹  Toshihiro Iwasaki²  Hisashi Sakamaki^4,7  Ritsuro Suzuki^4,10 

[1] Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan;Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan;Division of Hematology, Internal Medicine, National Center for Global Health and Medicine, Tokyo, Japan;Cellular Transplantation Biology (Hematology/Respirology), Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan;Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan;Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan;Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan;Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University Hospital, Fukuoka, Japan;Division of Hematology, Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan;Department of Hematopoietic Stem Cell Transplantation Data Management/Biostatistics, Nagoya University School of Medicine, Nagoya, Japan;Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

关键词: Autologous stem cell transplantation;    immunomodulator drugs;    International Staging System;    multiple myeloma;    proteasome inhibitors;   

DOI  :  10.1111/cas.12594

来源: Wiley

【 摘 要 】

Abstract

We evaluated the clinical significance of prognostic factors including the International Staging System (ISS) and modified European Group for Blood and Marrow Transplantation response criteria in 1650 Japanese patients with multiple myeloma (MM) who underwent upfront single autologous stem cell transplantation (ASCT). We categorized patients into two treatment cohorts: pre-novel agent era (1995–2006) and novel agent era (2008–2011). The combined percentage of pre-ASCT complete response and very good partial response cases (463 of 988, 47%) significantly increased during the novel agent era compared with the pre-novel agent era (164 of 527, 31%; P < 0.0001). The 2-year overall survival (OS) rate of 87% during the novel agent era was a significant improvement relative to that of 82% during the pre-novel agent era (P = 0.019). Although significant differences in OS were found among ISS stages during the pre-novel agent era, no significant difference was observed between ISS I and II (P = 0.107) during the novel agent era. The factors independently associated with a superior OS were female gender (P = 0.002), a good performance status (P = 0.024), lower ISS (P < 0.001), pre-ASCT response at least partial response (P < 0.001) and ASCT during the novel agent era (P = 0.017). These results indicate that the response rate and OS were significantly improved, and the ISS could not clearly stratify the prognoses of Japanese patients with MM who underwent upfront single ASCT during the novel agent era.

【 授权许可】

CC BY-NC   
© 2014 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.

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