Real-world long-term outcomes in multiple myeloma with VRD induction, Mel200-conditioned auto-HCT, and lenalidomide maintenance. Issue 3 (23rd February 2022)

• Record Type: Journal Article
• Authors: Gaballa, Mahmoud R.; Ma, Junsheng; Tanner, Mark R.; Al-Juhaishi, Taha; Bashir, Qaiser; Srour, Samer A.; Saini, Neeraj Y.; Ramdial, Jeremy L.; Nieto, Yago; Murphy, Regan; Rezvani, Katayoun; Tang, Guilin; Lee, Hans C.; Patel, Krina K.; Kaufman, Gregory P.; Manasanch, Elisabet E.; Ullah, Muhammad R.; Kebriaei, Partow; Thomas, Sheeba K.; Weber, Donna M.; Orlowski, Robert Z.; Shpall, Elizabeth J.; Champlin, Richard E.; Qazilbash, Muzaffar H.
• Is Part Of: Leukemia & lymphoma. Volume 63:Issue 3(2022)
• Page Start: 710
• Page End: 721
• Publication Date: 2022-02-23
• Subjects: Multiple myeloma -- transplantation -- VRD -- lenalidomide -- outcomes -- Mel200; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1992763
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Standard-of-care for newly-diagnosed, autologous hematopoietic stem cell transplantation (auto-HCT)-eligible, multiple myeloma (MM) patients includes bortezomib, lenalidomide, and dexamethasone (VRD) induction followed by melphalan 200 mg/m 2 (Mel200)-conditioned auto-HCT and lenalidomide maintenance. We completed a retrospective case series assessing outcomes of 187 MM patients who received this regimen at our institution. The 100-day non-relapse mortality incidence was zero. Before auto-HCT, 9.6 and 52.9% of patients achieved a complete response (CR) or ≥ very good partial response (VGPR), respectively. At day-100 post-transplant, 29.4 and 74.9% had achieved a CR/stringent-CR (sCR) or ≥ VGPR, respectively. At the last evaluation, 57.2% of patients had CR/sCR and 87.1% had ≥ VGPR. Median follow-up, progression-free survival (PFS), and overall survival (OS) were 63.2, 50, and 101.7 months, respectively. The 5-year PFS and OS were 43.1 and 79%. High-risk cytogenetics was associated with worse outcomes. This study illustrates that VRD induction, Mel200-conditioned auto-HCT, and lenalidomide maintenance are associated with good outcomes in MM.