Title:Outcomes of Patients with Heavily Pretreated Relapsed/Refractory Multiple Myeloma Receiving Salvage Cytotoxic Therapy with Supportive
Stem Cell Boost
Volume: 20
Issue: 2
Author(s): Ayrton Bangolo*, Samir Oza, Ronit Reich-Slotky, Aimee Chappell, David S. Siegel, Harsh Parmar, Noa Biran, David H. Vesole and Pooja Phull
Affiliation:
- Department of Internal Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ, 07047,
USA
Keywords:
Pretreated, stem cell boost, myeloma, cytotoxic therapy, salvage, relapsed/refractory.
Abstract:
Background: Multiple myeloma (MM) is an incurable hematologic malignancy characterized
by the neoplastic proliferation of plasma cells, which produce monoclonal immunoglobulin
that can cause vital organ damage, subsequently leading to significant morbidity and mortality.
Autologous hematopoietic stem cell transplant (ASCT) is the standard-of-care management of eligible
patients with newly diagnosed MM. Experts recommend collecting enough stem cells upfront
to support a possible tandem transplant, salvage ASCT, or a stem cell “boost” to allow for
the administration of multiagent cytotoxic chemotherapy in patients with relapsed/refractory disease.
Objective: There is currently a paucity of data on the response rates and outcomes of patients with
relapsed MM who undergo cytotoxic chemotherapy followed by a stem cell boost; this study examines
the outcomes of patients treated with this approach.
Methods: We conducted a retrospective chart review from two oncologic treatment centers in the
United States of adult patients who underwent a first ASCT between 1999 and 2021 and subsequently
received cytotoxic chemotherapy followed by stem cell boost further on in their disease
course. Survival analysis was carried out using the Kaplan-Meier method, and the log-rank test
was used to compare survival curves.
Results: We found that the majority (56.6%) of these patients responded to therapy and that
60.6% of these patients were able to receive at least one subsequent line of therapy post-boost.
Furthermore, patients who responded to therapy had significantly longer median overall survival
compared to those who did not respond (323 days vs 93 days, p=0.0045), and age did not affect response
to therapy.
Conclusion: This data allow clinicians to appropriately implement and inform patients of the therapeutic
uses and clinical outcomes of stem cell boost in patients with multiply relapsed/refractory
MM.
