Bortezomib Maintenance After Allogeneic Transplantation in Newly Diagnosed Myeloma Patients Results in Decreased Incidence and Severity of Chronic GVHD

Claveau, Jean-Sébastien; LeBlanc, Richard; Ahmad, Imran; Delisle, Jean-Sébastien; Cohen, Sandra; Kiss, Thomas; Bambace, Nadia M.; Bernard, Léa; Lachance, Silvy; Roy, Denis; Sauvageau, Guy; Veilleux, Olivier; Roy, Jean

doi:10.1016/j.jtct.2022.10.022

Cited by 2 publications

(1 citation statement)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, bortezomib favored a lower use of systemic steroids (45.1% vs. 76.4%, p < 0.001) and allowed a greater number of patients to discontinue immunosuppression (77% vs. 56%, p = 0.046). ( 72 ) As in the autologous transplantation setting, maintenance with the second-generation PI ixazomib has been tested in high-risk NDMM after allo-HSCT. Although incidence rates of acute and chronic GvHD were limited, a phase II double-blind trial did not show a survival advantage compared with the placebo group.…”

Section: The Role Of Maintenancementioning

confidence: 99%

Allogeneic stem cell transplantation in multiple myeloma: is there still a place?

Liberatore,

Fioritoni,

Di Ianni

2024

Front. Oncol.

View full text Add to dashboard Cite

The introduction of novel agents dramatically improved response and outcomes of multiple myeloma (MM) and led to a sharp decline in the use of allogeneic hematopoietic stem-cell transplantation (allo-HSCT). Thus, recent guidelines do not recommend anymore allo-HSCT as consolidation in the first-line treatment of newly diagnosed MM, even in high-risk patients. In a relapsed/refractory setting, allo-HSCT is not routinely recommended but should only be performed within clinical trials in young and high-risk patients. Nonetheless, allo-HSCT still represents a potential curative approach that has been used for decades in the treatment of MM and plasma cell neoplasms with favorable results and may still represent a treatment option for carefully selected patients. Despite that promising results were obtained with CAR T-cell therapies and bispecific antibodies in triple- and penta-exposed/refractory MM, these patients will inevitably relapse. To date, less is known about outcomes of allo-HSCT in patients exposed to novel immunotherapeutic drugs. Therefore, allo-HSCT could represent a reasonable treatment choice for younger and high-risk patients who have relapsed after CAR T-cell therapies and bispecific antibodies as well as an alternative for patients not eligible to these treatments and in those countries where immunotherapies are not yet available. In the choice of conditioning, reduced intensity conditioning regimens are currently recommended for the lower toxicity and mortality. Moreover, the use of alternative donors, particularly haploidentical, has progressively increased in last years with results comparable to full matched donors. Finally, post-transplantation maintenance strategies are encouraged whenever feasible.

show abstract

Section: The Role Of Maintenancementioning

confidence: 99%

Allogeneic stem cell transplantation in multiple myeloma: is there still a place?

Liberatore,

Fioritoni,

Di Ianni

2024

Front. Oncol.

View full text Add to dashboard Cite

show abstract

Efficacy and survival outcome of allogeneic stem-cell transplantation in multiple myeloma: meta-analysis in the recent 10 years

Lin,

Lu,

Zheng

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

IntroductionAllogeneic hematopoietic cell transplantation (alloHCT) possessed direct cytotoxicity and graft-versus-multiple myeloma effect (GvMM). Growing trials have shown survival benefits of performing alloHCT in both newly diagnosed and relapsed MM.MethodsWe aimed to provide a comprehensive analysis in the recent 10 years to verify the efficacy and survival outcome of alloHCT in MM patients. A total of 61 studies which provide data between 14/04/2013 and 14/04/2023 and a total of 15,294 data from MM patients who had undergone alloSCT were included in our study. The best response rates (CR, VGPR, PR) and survival outcomes (1-, 2-, 3-,5-, and 10-year OS, PFS, NRM) were assessed. We further conducted meta-analysis in the NDMM/frontline setting and RRMM/salvage setting independently.ResultsThe pooled estimate CR, VGPR, and PR rates were 0.45, 0.21, and 0.24, respectively. The pooled estimates of 1-, 2-, 3-, 5-, and 10-year OS were 0.69, 0.57, 0.45, 0.45, and 0.36, respectively; the pooled estimates of 1-, 2-, 3-, 5-, and 10-year PFS were 0.47, 0.35, 0.24, 0.25, and 0.28, respectively; and the pooled estimates of 1-, 2-, 3-, 5-, and 10-year NRM were 0.16, 0.21, 0.16, 0.20, and 0.15, respectively. In the NDMM/upfront setting, the pooled estimate CR rate was 0.54, and those for 5-year OS, PFS, and NRM were 0.69, 0.40, and 0.11, respectively. In a relapsed setting, the pooled estimate CR rate was 0.31, and those for 5-year OS, PFS, and NRM were 0.24, 0.10, and 0.15, respectively.DiscussionOur results showed constant OS, PFS, and NRM from the third year onwards till the 10th year, suggesting that alloSCT has sustained survival benefits. Good response rate and promising survival outcome were observed in the NDMM/ frontline setting.ConclusionAlthough comparing with other treatments, alloSCT had a lower response rate and poorer short-term survival outcome, long-term follow-up could reveal survival benefits of alloSCT in MM patients.

show abstract

Bortezomib Maintenance After Allogeneic Transplantation in Newly Diagnosed Myeloma Patients Results in Decreased Incidence and Severity of Chronic GVHD

Cited by 2 publications

References 44 publications

Allogeneic stem cell transplantation in multiple myeloma: is there still a place?

Allogeneic stem cell transplantation in multiple myeloma: is there still a place?

Efficacy and survival outcome of allogeneic stem-cell transplantation in multiple myeloma: meta-analysis in the recent 10 years

Contact Info

Product

Resources

About