Global characteristics and outcomes of autologous hematopoietic stem cell transplantation for newly diagnosed multiple myeloma: A study of the worldwide network for blood and marrow transplantation (WBMT)

Garderet L 1 , Gras L 2 , Koster L 3 , Baaij L 3 , Hamad N 4 , Dsouza A 5 Show all authors , Estrada-Merly N 6 , Hari P 7 , Saber W 5 , Cowan AJ 8 , Iida M 9 , Okamoto S 10 , Takamatsu H 11 , Mizuno S 12 , Kawamura K 13 , Kodera Y 14 , Ko BS 15 , Liam C 16 , Ho KW 17 , Goh AS 18 , Tan SK 18 , Elhaddad AM 19 , Bazarbachi A 20 , Chaudhry QUN 21 , Alfar R 22 , Bekadja MA 23 , Benakli M 24 , Ortiz CAF 25 , Riva E 26 , Galeano S 27 , Bass F 28 , Mian HS 29 , McCurdy A 30 , Wang FR 31 , Meng L 31 , Neumann D 32 , Koh M 33 , Snowden JA 34 , Schönland S 35 , McLornan DP 36 , Hayden PJ 37 , Sureda A 38 , Greinix HT 39 , Aljurf M 40 , Atsuta Y 41 , Niederwieser D 42

Affiliations 

  • 1 Service d'Hématologie, Sorbonne Université, Hopital Pitié Salpêtière APHP, Paris, France
  • 2 EBMT Statistical Unit, Leiden, Netherlands
  • 3 EBMT Data Office, Leiden, Netherlands
  • 4 Department of Haematology, School of Medicine, St Vincent's Hospital Sydney, St Vincent's Clinical School, University of New South Wales, University of Notre Dame Australia, Sydney, New South Wales, Australia
  • 5 Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  • 6 CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  • 7 Department of Hematology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  • 8 Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
  • 9 School of Medicine, Aichi Medical University, Aichi, Japan
  • 10 School of Medicine, Keio University, Tokyo, Japan
  • 11 School of Entrepreneurial and Innovation Studies, Kanazawa University, Kanazawa, Japan
  • 12 Department of Hematology, School of Medicine, Aichi Medical University, Nagakute, Japan
  • 13 Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
  • 14 Department of Promotion for Blood and Marrow Transplantation, School of Medicine, Aichi Medical University, Nagoya, Japan
  • 15 Department of Hematology, National Taiwan University Hospital, Taipei, Taiwan
  • 16 Department of Hematology, Hospital Ampang, Ampang, Malaysia
  • 17 Department of Hematology, Ampang Hospital, Ampang Jaya, Malaysia
  • 18 Penang General hospital, Penang, Malaysia
  • 19 Department of Pediatric Oncology and Stem Cell Transplantation Unit, National Cancer Institute, Cairo University, Cairo, Egypt
  • 20 Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  • 21 AFBMTC/NIBMT, Rawalpindi, Pakistan
  • 22 King Hussein Cancer center, Amman, Jordan
  • 23 Department of Hematology and Cell Therapy, EHU 1st Novembre 1954 Bir el Djir Usto, University Ahmed Benbella 1, Oran, Algeria
  • 24 Centre Pierre et Marie Curie (CPMC), Algiers, Algeria
  • 25 Hospital Central Del Instituto De Prevision Social, Asuncion, Paraguay
  • 26 Facultad de Medicina, Cátedra de Hematología, Hospital de Clínicas, Montevideo, Uruguay
  • 27 Hematology Department, British Hospital, Montevideo, Uruguay
  • 28 Hospital del Salvador, Santiago, Chile
  • 29 Department of Oncology, McMaster University, Hamilton, Canada
  • 30 Department of Medicine, Division of Hematology, The Ottawa Hospital, Ottawa, Canada
  • 31 Department of Hematology, Peking University, Beijing, China
  • 32 IMISE, University of Leipzig, Leipzig, Germany
  • 33 Infection and Immunity Clinical Academic Group St George's, University of London, London, UK
  • 34 BSBMTCT, Department of Haematology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
  • 35 Department of Internal Medicine V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
  • 36 Department of Haematology, Kings's College Hospital, London, UK
  • 37 Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
  • 38 Institut Català d'Oncologia, Hospital Duran i Reynals, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
  • 39 Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
  • 40 Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
  • 41 Japanese Data Center for Hematopoietic Cell Transplantation, Department of Registry Science for Transplant and Cellular Therapy, School of Medicine, Aichi Medical University, Nagakute, Japan
  • 42 Department of Hematology, University of Leipzig, Leipzig, Germany
Am J Hematol, 2024 Aug 19.
PMID: 39158218 DOI: 10.1002/ajh.27451

Abstract

Autologous hematopoietic cell transplantation (AHCT) is a commonly used treatment in multiple myeloma (MM). However, real-world global demographic and outcome data are scarce. We collected data on baseline characteristics and outcomes from 61 725 patients with newly diagnosed MM who underwent upfront AHCT between 2013 and 2017 from nine national/international registries. The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS), relapse incidence (RI) and non-relapse mortality (NRM). Median OS amounted to 90.2 months (95% CI 88.2-93.6) and median PFS 36.5 months (95% CI 36.1-37.0). At 24 months, cumulative RI was 33% (95% CI 32.5%-33.4%) and NRM was 2.5% (95% CI 2.3%-2.6%). In the multivariate analysis, superior outcomes were associated with younger age, IgG subtype, complete hematological response at auto-HCT, Karnofsky score of 100%, international staging scoring (ISS) stage 1, HCT-comorbidity index (CI) 0, standard cytogenetic risk, auto-HCT in recent years, and use of lenalidomide maintenance. There were differences in the baseline characteristics and outcomes between registries. While the NRM was 1%-3% at 12 months worldwide, the OS at 36 months was 69%-84%, RI at 12 months was 12%-24% and PFS at 36 months was 43%-63%. The variability in these outcomes is attributable to differences in patient and disease characteristics as well as the use of maintenance and macroeconomic factors. In conclusion, worldwide data indicate that AHCT in MM is a safe and effective therapy with an NRM of 1%-3% with considerable regional differences in OS, PFS, RI, and patient characteristics. Maintenance treatment post-AHCT had a beneficial effect on OS.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Similar publications