The following is a summary of “Clinical factors associated with autologous stem cell transplantation outcomes in multiple myeloma: upfront transplant with MEL200 remains the standard of care,” published in the October 2023 issue of Hematology by Değirmenci et al.

Researchers started a retrospective study investigating prognostic markers for Autologous stem cell transplantation (ASCT) in newly diagnosed transplant-eligible multiple myeloma (MM) patients.

They explored potential prognostic markers that could have influenced the transplant outcomes in 256 ASCT recipients [median age: 58 (30–74) years; male/female: 138/118]. This included an examination of pretransplant (PET_O) and day + 60 (PET₂) PET/CT assessments, along with a comparative analysis of melphalan (Mel) dosage.

The results showed patients who underwent transplants within 301 days from diagnosis achieved notably higher complete response/excellent partial response rates (P<0.001). Patients with fewer than 1.5 lines of treatment before transplant had a significantly improved probability of overall survival (OS) (P=0.004) and progression-free survival (PFS) (P<0.001). Patients with a low Eastern Cooperative Oncology Group (ECOG) performance score (PS = 0–1) (P=0.003) and HCT-Comorbidity Index (HCT-CI = 0) (P=0.011) had significantly higher OS probability. The number of involved areas (P=0.028) and maximum standardized uptake value (SUV_max) (P=0.021) in PET_O had a significant impact on OS.Mel200 mg/m² conditioning significantly improved OS (P<0.001) and PFS (P=0.01) compared to Mel140 mg/m².Mel200 mg/m² conditioning, early upfront ASCT, and low pretransplant treatment burden significantly influenced ASCT outcomes in MM patients.

They concluded that PET/CT-based response assessments need standardization before clinical use.

Source: link.springer.com/article/10.1007/s00277-023-05511-z