Current status of autologous stem cell transplantation for multiple myeloma

Hamed, Rama Al; Bazarbachi, Abdul-Hamid; Malard, Florent; Harousseau, Jean‐Luc; Mohty, Mohamad

doi:10.1038/s41408-019-0205-9

Cited by 181 publications

(140 citation statements)

References 105 publications

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“…Maintenance therapy was considered to be a good prognostic factor for PFS in our study [30][31][32]. It has been more than 30 years of connection of chemotherapy to autologous stem cell transplantation (ASCT), which remains a standard care for few patients with newly diagnosed MM [33][34][35]. Our study also supported this, and ASCT after chemotherapy was regarded as protective factor for both PFS and OS.…”

Section: Discussionsupporting

confidence: 75%

The reduction rate of M protein after first and fourth cycle chemotherapy predicts the outcome in patients initially diagnosed with multiple myeloma

Zhang

Wei-e

et al. 2020

Preprint

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Background: Multiple myeloma (MM) is a hematologic malignancy that originate from a malignant clone of plasma cells. This study aimed to discover the reduction rate of monoclonal (M) protein after first and fourth cycle chemotherapy, which acts as a new prognostic factor for progression-free survival (PFS) in MM patients. Methods: We retrospectively analyzed 164 patients with MM. The overall survival (OS) and PFS from the time of first diagnosis were measured. Cox proportional hazards model was used to evaluate if the reduction rate of M protein after first to fourth cycle chemotherapy effect PFS and OS. . Results: Multivariate analysis was performed with factors including del(17p), t(14;16), t(14;20), ISS stage, age, AST and others parameters. The reduction rate of M protein after first cycle chemotherapy (C1reduction rate) (P<0.001) and the reduction rate of M protein after fourth cycle chemotherapy (C4 reduction rate) (P<0.001) acts as dependent predictors of PFS. The 36 months PFS rate in patients with a reduction rate of M protein after the first cycle chemotherapy was compared. The reduction rate of ≥25 vs <25% showed no difference, while the reduction rate of ≥50 vs <50% showed significant difference in PFS. Meanwhile, the reduction rate of M protein after the fourth cycle chemotherapy ≥25 vs <25%, ≥50 vs <50% showed no meaning, but the groups of ≥75 vs <75% showed significant differences in PFS. The patients with higher reduction rate in these two stages had longer PFS. Conclusions :Higher reduction rate of M protein after first and and fourth cycle of chemotherapy act as advantageous prognostic factors for PFS in MM patients in the initial diagnosis.

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Section: Discussionsupporting

confidence: 75%

The reduction rate of M protein after first and fourth cycle chemotherapy predicts the outcome in patients initially diagnosed with multiple myeloma

Zhang

Wei-e

et al. 2020

Preprint

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“…With advances made in medical treatment and autologous stem cell transplantation (ASCT), clinical response and survival rates of multiple myeloma (MM) have improved. High dose melphalan (200 mg/m 2 ) is the international standard for conditioning before ASCT for MM [1,2]. Cardiac toxicity in the form of supraventricular tachycardia (SVT) and atrial fibrillation (AF) are common after high dose melphalan therapy [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

A case report: high dose melphalan as a conditioning regimen for multiple myeloma induces sinus arrest

Liu

Jia

et al. 2020

Cardio-Oncology

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High dose melphalan is commonly used as a conditioning regimen for autologous stem cell transplantation in multiple myeloma. There are reports of adverse cardiac events with melphalan manifested by supraventricular tachycardia and atrial fibrillation. Here, we report a rare case of a 58 year old female with multiple myeloma, who developed sinus arrest after autologous stem cell transplantation using high dose melphalan as a conditioning regimen. It was severe and rare, therefore, monitoring for cardiac toxicity in patients receiving high-dose melphalan is mandatory.

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“…Upfront induction treatment in MM has two main goals; as early as possible response in order to achieve rapid disease control and as deep as possible response in order to proceed to ASCT safely and improve outcomes [47]. MRD negativity following induction may be considered as the optimal depth of response, which is associated with improved survival outcomes [16,35,48].…”

Section: Optimizing Induction Regimensmentioning

confidence: 99%