The effect of salvage autologous stem-cell transplantation on overall survival in patients with relapsed multiple myeloma (final results from BSBMT/UKMF Myeloma X Relapse [Intensive]): a randomised, open-label, phase 3 trial

Cook, Gordon; Ashcroft, A. John; Cairns, David A.; Williams, Cathy; Brown, Julia; Cavenagh, Jamie; Snowden, John A.; Parrish, Christopher; Yong, Kwee; Cavet, Jim; Hunter, Hannah; Bird, Jenny; Pratt, Guy; Chown, Sally; Heartin, Earnest; O’Connor, Sheila J.M.; Drayson, Mark T.; Hockaday, Anna; Morris, T. C. M.

doi:10.1016/s2352-3026(16)30049-7

Cited by 129 publications

(112 citation statements)

References 33 publications

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“…Their findings confirm the results from many other similar retrospective and prospective studies conducted in Europe and the USA which demonstrate that salvage ASCT in relapsed MM is feasible [2, 3]. They demonstrate that patients enjoying a longer relapse-free survival after their first ASCT appear to do the best in terms of survival postsalvage ASCT.…”

supporting

confidence: 87%

Second Autologous Hematopoietic Stem Cell Transplant as Salvage Therapy for Relapsed Multiple Myeloma: A Global Treatment Option for Eligible Patients

Gonsalves

Kansagra

2018

Acta Haematol

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supporting

confidence: 87%

Second Autologous Hematopoietic Stem Cell Transplant as Salvage Therapy for Relapsed Multiple Myeloma: A Global Treatment Option for Eligible Patients

Gonsalves

Kansagra

2018

Acta Haematol

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“…89 Moreover, overall survival for patients randomized to a second ASCT was higher than for controls (67 months vs 52 months; P =.0169). 153 Given that these patients did not receive any maintenance therapy after their second ASCT, the duration of the response is acceptable. There is increasing evidence of benefit of ASCT even in the older population, and therefore patients should be referred for evaluation to a transplant center because ASCT can have a positive effect on survival in this population.…”

Section: Therapy For Patients In First Relapsementioning

confidence: 99%

Therapy for Relapsed Multiple Myeloma

Dingli

Ailawadhi

Bergsagel

et al. 2017

Mayo Clinic Proceedings

120

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Life expectancy in patients with multiple myeloma is increasing because of the availability of an increasing number of novel agents with various mechanisms of action against the disease. However, the disease remains incurable in most patients because of the emergence of resistant clones, leading to repeated relapses of the disease. In 2015, 5 novel agents were approved for therapy for relapsed multiple myeloma. This surfeit of novel agents renders management of relapsed multiple myeloma more complex because of the occurrence of multiple relapses, the risk of cumulative and emergent toxicity from previous therapies, as well as evolution of the disease during therapy. A group of physicians at Mayo Clinic with expertise in the care of patients with multiple myeloma regularly evaluates the evolving literature on the biology and therapy for multiple myeloma and issues guidelines on the optimal care of patients with this disease. In this article, the latest recommendations on the diagnostic evaluation of relapsed multiple myeloma and decision trees on how to treat patients at various stages of their relapse (off study) are provided together with the evidence to support them.

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“…Prognostic factors associated with prolonged PFS in these reports included quality and duration of response to the first high‐dose therapy (ASCT1), the number of lines of therapy before salvage ASCT (ASCT2), younger age, and lower β‐2‐microglobuline at diagnosis . The BSBMT/UKMF myeloma X trial for relapsed MM patients represents so far the only prospective study that compared salvage ASCT with continued conventional chemotherapy (weekly cyclophosphamide), and the trial reported a significant benefit for PFS and OS for the ASCT arm . However, more potent alternatives to salvage ASCT have become available, and their direct comparison to salvage ASCT remains untested.…”

Section: Introductionmentioning

confidence: 99%

Prolonged survival after second autologous transplantation and lenalidomide maintenance for salvage treatment of myeloma patients at first relapse after prior autograft

Gössi

Jeker

Taleghani

et al. 2018

Hematological Oncology

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Autologous stem cell transplantation (ASCT) as part of the primary therapy in multiple myeloma (MM) is standard practice. In contrast, the role of a second ASCT (ASCT2) and subsequent lenalidomide maintenance for relapsed disease remains unclear. In this study, we analysed 86 consecutive MM patients with a first relapse after prior ASCT receiving either a second ASCT or conventional chemotherapy. After a median follow-up of 37.7 months since first relapse, 54 (62.8%) patients were still alive and 29 (33.7%) without progression. Sixty-one (71.0%) patients received ASCT2 and had better progression-free survival (PFS) (30.2 versus 13.0 mo; P = .0262) and overall survival (OS) rates (129.6 versus 33.5 mo; P = .0003) compared with 25 (29.0%) patients with conventional treatment. Patients relapsing later than 12 months after ASCT1 benefitted from a second ASCT with better PFS2 (P = .0179) and OS2 (P = .0009). Finally, lenalidomide maintenance after ASCT2 was associated with longer PFS (41.0 vs 21.6 mo; P = .0034) and better OS (not yet reached vs 129.6 mo; P = .0434) compared with patients without maintenance. Our data suggest that a second ASCT and lenalidomide maintenance given at first relapse in MM after prior ASCT are associated with better survival rates.

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The effect of salvage autologous stem-cell transplantation on overall survival in patients with relapsed multiple myeloma (final results from BSBMT/UKMF Myeloma X Relapse [Intensive]): a randomised, open-label, phase 3 trial

Abstract: Cancer Research UK, Janssen-Cilag, and Chugai Pharma UK.

Cited by 129 publications

References 33 publications

Second Autologous Hematopoietic Stem Cell Transplant as Salvage Therapy for Relapsed Multiple Myeloma: A Global Treatment Option for Eligible Patients

Second Autologous Hematopoietic Stem Cell Transplant as Salvage Therapy for Relapsed Multiple Myeloma: A Global Treatment Option for Eligible Patients

Therapy for Relapsed Multiple Myeloma

Prolonged survival after second autologous transplantation and lenalidomide maintenance for salvage treatment of myeloma patients at first relapse after prior autograft

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