In a nutshell
This paper studied the use of novel drugs with salvage autologous stem cell transplant in relapsed multiple myeloma. This study concluded that salvage autologous stem cell transplant is safe and effective for patients with relapsed multiple myeloma.
Some background
For patients with newly diagnosed multiple myeloma aged up to 65-70 years, chemotherapy followed by autologous stem cell transplantation (aSCT) is the standard treatment. aSCT is a procedure where stem cells (immature blood cells) are collected before induction chemotherapy and transferred back into the body after chemotherapy. Almost all patients will eventually relapse (have a return of cancer). The use of aSCT at relapse, known as salvage aSCT (saSCT), is an appealing option. Novel agents such as bortezomib (Velcade) have been used as induction before aSCT. Initial studies of saSCT together with induction using novel drugs has shown benefit.
Methods & findings
Data from 66 patients with multiple myeloma were studied. These patients had relapsed and had undergone a saSCT. 87% of patients received induction with bortezomib before transplant. Patients were followed for an average of 24 months.
The overall response rate to induction therapy was 83%. 48% of patients had a high quality response, and 18% of patients had a complete response (no sign of disease). The overall response rate was higher in patients who received bortezomib compared to patients who received other induction therapy. 77% of patients had at least a very good partial response to saSCT. 44% had a complete response.
55% of patients had a severe or life-threatening adverse event (undesired effect of treatment). These were all manageable. Two patients died within 100 days of the saSCT. 48% of patients had gastrointestinal adverse events. Severe blood clots occurred in 4% of patients.
The average survival without any event (such as disease progression) was 17 months. The overall survival (time from treatment until death from any cause) after saSCT was 43 months.
The bottom line
The authors concluded that treatment with novel drugs before salvage autologous stem cell transplant is safe and effective for patients with relapsed multiple myeloma.
What’s next?
Talk to your doctor about having salvage autologous stem cell transplant.
Published By :
Annals of Hematology
Date :
Oct 24, 2017
