Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma

Background—Autologous stem cell transplant (ASCT) is integral to the treatment of multiple myeloma (MM), although its absolute necessity in first remission has been recently questioned. We report real-world factors that influence clinical decision-making and outcomes from ASCT in 733 patients with M...

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Main Authors: Lisa Blackburn, Anthony Mansour, Qiuhong Zhao, Francesca Cottini, Abdullah Khan, Naresh Bumma, Srinivas Devarakonda, Elvira Umyarova, Ashley E. Rosko, Jennifer Vaughn, Nidhi Sharma, Don M. Benson
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Hemato
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Online Access:https://www.mdpi.com/2673-6357/5/4/30
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author Lisa Blackburn
Anthony Mansour
Qiuhong Zhao
Francesca Cottini
Abdullah Khan
Naresh Bumma
Srinivas Devarakonda
Elvira Umyarova
Ashley E. Rosko
Jennifer Vaughn
Nidhi Sharma
Don M. Benson
author_facet Lisa Blackburn
Anthony Mansour
Qiuhong Zhao
Francesca Cottini
Abdullah Khan
Naresh Bumma
Srinivas Devarakonda
Elvira Umyarova
Ashley E. Rosko
Jennifer Vaughn
Nidhi Sharma
Don M. Benson
author_sort Lisa Blackburn
collection DOAJ
description Background—Autologous stem cell transplant (ASCT) is integral to the treatment of multiple myeloma (MM), although its absolute necessity in first remission has been recently questioned. We report real-world factors that influence clinical decision-making and outcomes from ASCT in 733 patients with MM. Results—Similar to recent prospective data, we found a significant progression-free survival (PFS) benefit with early versus deferred ASCT (median PFS of 5.1 years versus 2.6 years, <i>p</i> < 0.001); however, there was no significant difference in overall survival (median OS of 8.3 years and 8.6 years, <i>p</i> = 0.21). Patient preference, age, marital status, body mass index, and comorbidities influence ASCT timing. Conclusion—These findings highlight the emerging role of an individualized, shared decision-making model regarding the timing of ASCT between patients and physicians with the myriad of treatment options available in the contemporary era.
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series Hemato
spelling doaj-art-74fea70754cd49ecb2ce6793d2d86f152024-12-27T14:28:38ZengMDPI AGHemato2673-63572024-10-015440741910.3390/hemato5040030Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple MyelomaLisa Blackburn0Anthony Mansour1Qiuhong Zhao2Francesca Cottini3Abdullah Khan4Naresh Bumma5Srinivas Devarakonda6Elvira Umyarova7Ashley E. Rosko8Jennifer Vaughn9Nidhi Sharma10Don M. Benson11Division of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USADivision of Hematology, Department of Internal Medicine, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, 308 Wiseman Hall, 400 W. 10th Avenue, Columbus, OH 43210, USABackground—Autologous stem cell transplant (ASCT) is integral to the treatment of multiple myeloma (MM), although its absolute necessity in first remission has been recently questioned. We report real-world factors that influence clinical decision-making and outcomes from ASCT in 733 patients with MM. Results—Similar to recent prospective data, we found a significant progression-free survival (PFS) benefit with early versus deferred ASCT (median PFS of 5.1 years versus 2.6 years, <i>p</i> < 0.001); however, there was no significant difference in overall survival (median OS of 8.3 years and 8.6 years, <i>p</i> = 0.21). Patient preference, age, marital status, body mass index, and comorbidities influence ASCT timing. Conclusion—These findings highlight the emerging role of an individualized, shared decision-making model regarding the timing of ASCT between patients and physicians with the myriad of treatment options available in the contemporary era.https://www.mdpi.com/2673-6357/5/4/30myelomaearly transplantdeferred transplantoutcomesdecision-making
spellingShingle Lisa Blackburn
Anthony Mansour
Qiuhong Zhao
Francesca Cottini
Abdullah Khan
Naresh Bumma
Srinivas Devarakonda
Elvira Umyarova
Ashley E. Rosko
Jennifer Vaughn
Nidhi Sharma
Don M. Benson
Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
Hemato
myeloma
early transplant
deferred transplant
outcomes
decision-making
title Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
title_full Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
title_fullStr Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
title_full_unstemmed Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
title_short Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
title_sort real world predictors timing and outcomes of autologous stem cell transplantation in patients with multiple myeloma
topic myeloma
early transplant
deferred transplant
outcomes
decision-making
url https://www.mdpi.com/2673-6357/5/4/30
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