In a nutshell
This study explored the role of maintenance therapy after a second autologous hematopoietic cell transplant (AHCT2) in patients with multiple myeloma (MM). The data showed that maintenance therapy after AHCT2 was associated with better outcomes in these patients.
MM is commonly hard-to-treat. Many patients are treated first with high-dose chemotherapy to kill cancer cells followed by AHCT (harvesting of patient’s blood-making stem cells for use during a bone marrow transplant). Maintenance therapy is given after high-dose chemotherapy and first AHCT (AHCT1) to keep the cancer from coming back.
However, some patients have cancer relapse after this treatment. These patients may require a second AHCT (AHCT2). However, the use of maintenance therapy in these patients after AHCT2 remains unclear.
Methods & findings
This study included 522 adult patients with MM who underwent AHCT2 after melphalan (Alkeran)-based chemotherapy. After AHCT 2, 342 patients received maintenance therapy while 180 patients did not. For maintenance, 42% of patients were given lenalidomide (Revlimid), 13% had pomalidomide (Pomalyst) and 13% received bortezomib (Velcade). The average follow-up period was 58 months for the maintenance group and 61.5 months for the non-maintenance group.
Significantly more patients in the non-maintenance group had a relapse (80.3%) after 5 years compared to those in the maintenance group (70.2%). Also, significantly more patients in the maintenance group were alive without cancer worsening after 5 years (27.8%) compared to those in the non-maintenance group (9.8%). Significantly more patients in the maintenance group were alive after 5 years (54%) compared to those in the non-maintenance group (30.9%)
Patients who received lenalidomide– or pomalidomide-based maintenance had better outcomes compared to other medications.
The bottom line
The study showed that the use of maintenance therapy after AHCT2 in patients with MM improved their outcomes.
The fine print
This study was based on data from medical records. Patients were not randomly assigned to the two groups. This may have influenced the results.
Published By :
Bone Marrow Transplantation
Oct 04, 2021
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