Salvage Autologous Stem Cell Transplantation in Daratumumab-Refractory Multiple Myeloma

Cancers

Meera Mohan¹  Reid D. Landes²  Carolina Schinke³  Maurizio Zangari³  Lakshmi Yarlagadda³  Guido Tricot³  Sharmilan Thanendrarajan³  Richa Parikh³  Mathew Kottarathara³  Kerri M. Hill³  Monica Graziutti³  Clyde Bailey³  Angel A. Mitma³  Yetunde Ogunsesan³  Frits van Rhee³  Sravani Gundarlapalli³  Shadiqul Hoque³ 

[1] Cancer Center, Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;Myeloma Center, Division of Hematology/Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;

关键词: multiple myeloma;    daratumumab;    autologous stem cell transplantation;   

DOI  :  10.3390/cancers13164019

来源: DOAJ

【 摘 要 】

Daratumumab, a CD38-targeting monoclonal antibody, has significantly improved survival rates in multiple myeloma (MM), yet patients who progress on Daratumumab have dismal clinical outcomes with an overall median of less than 10 months. While emerging novel modalities have shown promising results, the current study explores the use of high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) in heavily pretreated Daratumumab-refractory MM patients. We retrospectively investigated the outcome of 69 consecutive patients who received upfront ASCT. The median progression-free survival (PFS) for the entire patient cohort was 7.2 months with a median overall survival (OS) of 19.3 months. For patients with ≥very good partial response (VGPR), median PFS and OS improved to 9 months and 34 months, respectively. Achievement of MRD negativity in ≥VGPR did not further improve the outcome. A better performance status, younger age, longer time interval from initial MM diagnosis/initial ASCT to salvage ASCT and low-risk GEP70 were all associated with improved PFS and OS after salvage ASCT. Our results suggest a role for salvage ASCT in selected heavily pretreated and Daratumumab-refractory patients.

【 授权许可】

Unknown