PMID- 27496215
OWN - NLM
STAT- MEDLINE
DCOM- 20180126
LR  - 20240213
IS  - 1523-6536 (Electronic)
IS  - 1083-8791 (Print)
IS  - 1083-8791 (Linking)
VI  - 22
IP  - 10
DP  - 2016 Oct
TI  - Post-Transplant Outcomes in High-Risk Compared with Non-High-Risk Multiple 
      Myeloma: A CIBMTR Analysis.
PG  - 1893-1899
LID - S1083-8791(16)30223-3 [pii]
LID - 10.1016/j.bbmt.2016.07.007 [doi]
AB  - Conventional cytogenetics and interphase fluorescence in situ hybridization 
      (FISH) identify high-risk multiple myeloma (HRM) populations characterized by 
      poor outcomes. We analyzed these differences among HRM versus non-HRM populations 
      after upfront autologous hematopoietic cell transplantation (autoHCT). Between 
      2008 and 2012, 715 patients with multiple myeloma identified by FISH and/or 
      cytogenetic data with upfront autoHCT were identified in the Center for 
      International Blood and Marrow Transplant Research database. HRM was defined as 
      del17p, t(4;14), t(14;16), hypodiploidy (<45 chromosomes excluding -Y) or 
      chromosome 1 p and 1q abnormalities; all others were non-HRM. Among 125 HRM 
      patients (17.5%), induction with bortezomib and immunomodulatory agents (imids) 
      was higher compared with non-HRM (56% versus 43%, P < .001) with similar 
      pretransplant complete response (CR) rates (14% versus 16%, P .1). At day 100 
      post-transplant, at least a very good partial response was 59% in HRM and 61% in 
      non-HRM (P = .6). More HRM patients received post-transplant therapy with 
      bortezomib and imids (26% versus 12%, P = .004). Three-year post-transplant 
      progression-free (PFS) and overall survival (OS) rates in HRM versus non-HRM were 
      37% versus 49% (P < .001) and 72% versus 85% (P < .001), respectively. At 3 
      years, PFS for HRM patients with and without post-transplant therapy was 46% (95% 
      confidence interval [CI], 33 to 59) versus 14% (95% CI, 4 to 29) and in non-HRM 
      patients with and without post-transplant therapy 55% (95% CI, 49 to 62) versus 
      39% (95% CI, 32 to 47); rates of OS for HRM patients with and without 
      post-transplant therapy were 81% (95% CI, 70 to 90) versus 48% (95% CI, 30 to 65) 
      compared with 88% (95% CI, 84 to 92) and 79% (95% CI, 73 to 85) in non-HRM 
      patients with and without post-transplant therapy, respectively. Among patients 
      receiving post-transplant therapy, there was no difference in OS between HRM and 
      non-HRM (P = .08). In addition to HRM, higher stage, less than a CR 
      pretransplant, lack of post-transplant therapy, and African American race were 
      associated with worse OS. In conclusion, we show HRM patients achieve similar day 
      100 post-transplant responses compared with non-HRM patients, but these responses 
      are not sustained. Post-transplant therapy appeared to improve the poor outcomes 
      of HRM.
CI  - Copyright (c) 2016 The American Society for Blood and Marrow Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Scott, Emma C
AU  - Scott EC
AD  - Center for Hematologic Malignancies, The Knight Cancer Institute, Oregon Health 
      and Science University, Portland, Oregon.
FAU - Hari, Parameswaran
AU  - Hari P
AD  - Center for International Blood and Marrow Transplant Research, Department of 
      Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
FAU - Sharma, Manish
AU  - Sharma M
AD  - Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson 
      University, Philadelphia, Pennsylvania.
FAU - Le-Rademacher, Jennifer
AU  - Le-Rademacher J
AD  - Center for International Blood and Marrow Transplant Research, Department of 
      Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of 
      Biostatistics, Institute for Health and Society, Medical College of Wisconsin, 
      Milwaukee, Wisconsin.
FAU - Huang, Jiaxing
AU  - Huang J
AD  - Center for International Blood and Marrow Transplant Research, Department of 
      Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
FAU - Vogl, Dan
AU  - Vogl D
AD  - Department of Medicine, Abramson Cancer Center, University of Pennsylvania, 
      Philadelphia, Pennsylvania.
FAU - Abidi, Muneer
AU  - Abidi M
AD  - Division of BMT, Department of Oncology, Karmanos Cancer Institute, Wayne State 
      University, Detroit, Michigan.
FAU - Beitinjaneh, Amer
AU  - Beitinjaneh A
AD  - Department of Medicine, University of Miami, Miami, Florida.
FAU - Fung, Henry
AU  - Fung H
AD  - Department of Medical Oncology, Fox Chase Cancer Center, Temple Health, 
      Philadelphia, Pennsylvania.
FAU - Ganguly, Siddhartha
AU  - Ganguly S
AD  - Blood and Marrow Transplantation, University of Kansas Medical Center, Kansas 
      City, Kansas.
FAU - Hildebrandt, Gerhard
AU  - Hildebrandt G
AD  - Hematology and BMT, University of Kentucky Chandler Medical Center, Lexington, 
      Kentucky.
FAU - Holmberg, Leona
AU  - Holmberg L
AD  - Department of Medicine and Oncology, Fred Hutchinson Cancer Research Center, 
      Seattle, Washington.
FAU - Kalaycio, Matt
AU  - Kalaycio M
AD  - Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic 
      Foundation, Cleveland, Ohio.
FAU - Kumar, Shaji
AU  - Kumar S
AD  - Department of Medicine, Mayo Clinic Rochester, Rochester, Minnesota.
FAU - Kyle, Robert
AU  - Kyle R
AD  - Department of Medicine, Mayo Clinic Rochester, Rochester, Minnesota.
FAU - Lazarus, Hillard
AU  - Lazarus H
AD  - Division of Hematology and Oncology, Seidman Cancer Center, University Hospitals 
      Case Medical Center, Cleveland, Ohio.
FAU - Lee, Cindy
AU  - Lee C
AD  - Division of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, 
      Australia.
FAU - Maziarz, Richard T
AU  - Maziarz RT
AD  - Adult Blood and Marrow Stem Cell Transplant Program, Knight Cancer Institute, 
      Oregon Health and Science University, Portland, Oregon.
FAU - Meehan, Kenneth
AU  - Meehan K
AD  - Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New 
      Hampshire.
FAU - Mikhael, Joseph
AU  - Mikhael J
AD  - Department of Medicine, Mayo Clinic Arizona and Phoenix Children's Hospital, 
      Scottsdale, Arizona.
FAU - Nishihori, Taiga
AU  - Nishihori T
AD  - Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and 
      Research Institute, Tampa, Florida.
FAU - Ramanathan, Muthalagu
AU  - Ramanathan M
AD  - Division of Hematology and Oncology, Department of Medicine, UMass Memorial 
      Medical Center, Worchester, Massachusetts.
FAU - Usmani, Saad
AU  - Usmani S
AD  - Department of Hematology-Medical Oncology, Levine Cancer Institute, Carolinas 
      HealthCare System, Charlotte, North Carolina.
FAU - Tay, Jason
AU  - Tay J
AD  - Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
FAU - Vesole, David
AU  - Vesole D
AD  - Myeloma Division, John Theurer Cancer Center at Hackensack UMC, Hackensack, New 
      Jersey.
FAU - Wirk, Baldeep
AU  - Wirk B
AD  - Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, 
      Washington.
FAU - Yared, Jean
AU  - Yared J
AD  - Blood & Marrow Transplantation Program, Division of Hematology/Oncology, 
      Department of Medicine, Greenebaum Cancer Center, University of Maryland, 
      Baltimore, Maryland.
FAU - Savani, Bipin N
AU  - Savani BN
AD  - Division of Hematology/Oncology, Department of Medicine, Vanderbilt University 
      Medical Center, Nashville, Tennessee.
FAU - Gasparetto, Cristina
AU  - Gasparetto C
AD  - Department of Medicine, Duke University Medical Center, Durham, North Carolina.
FAU - Krishnan, Amrita
AU  - Krishnan A
AD  - Department of Hematology and Hematopoietic Cell Transplantation, City of Hope 
      National medical Center, Duarte, California.
FAU - Mark, Tomer
AU  - Mark T
AD  - Department of Medicine, Weill Cornell Medical College, New York, New York.
FAU - Nieto, Yago
AU  - Nieto Y
AD  - Department of Stem Cell Transplantation, MD Anderson Cancer Center, Houston, 
      Texas.
FAU - D'Souza, Anita
AU  - D'Souza A
AD  - Center for International Blood and Marrow Transplant Research, Department of 
      Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: 
      andsouza@mcw.edu.
LA  - eng
GR  - P30 CA006927/CA/NCI NIH HHS/United States
GR  - U01 HL069294/HL/NHLBI NIH HHS/United States
GR  - U10 HL069294/HL/NHLBI NIH HHS/United States
GR  - U24 CA076518/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20160802
PL  - United States
TA  - Biol Blood Marrow Transplant
JT  - Biology of blood and marrow transplantation : journal of the American Society for 
      Blood and Marrow Transplantation
JID - 9600628
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cytogenetic Analysis
MH  - Databases, Factual
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/*genetics/mortality/*therapy
MH  - Retrospective Studies
MH  - Risk Assessment/*methods
MH  - Survival Analysis
MH  - Transplantation, Autologous
MH  - Treatment Outcome
PMC - PMC5090978
MID - NIHMS820001
OTO - NOTNLM
OT  - Autologous HSCT
OT  - High risk
OT  - Maintenance
OT  - Multiple myeloma
EDAT- 2016/08/09 06:00
MHDA- 2018/01/27 06:00
PMCR- 2017/10/01
CRDT- 2016/08/07 06:00
PHST- 2016/05/16 00:00 [received]
PHST- 2016/07/15 00:00 [accepted]
PHST- 2016/08/07 06:00 [entrez]
PHST- 2016/08/09 06:00 [pubmed]
PHST- 2018/01/27 06:00 [medline]
PHST- 2017/10/01 00:00 [pmc-release]
AID - S1083-8791(16)30223-3 [pii]
AID - 10.1016/j.bbmt.2016.07.007 [doi]
PST - ppublish
SO  - Biol Blood Marrow Transplant. 2016 Oct;22(10):1893-1899. doi: 
      10.1016/j.bbmt.2016.07.007. Epub 2016 Aug 2.