Primary refractory multiple myeloma: a real-world experience with 85 cases.

Area of Science:

• Hematology
• Oncology
• Clinical Medicine

Background:

• Multiple myeloma (MM) patients refractory to initial therapies face limited treatment options.
• Assessing prognosis and optimal treatment sequencing is crucial for refractory MM.

Purpose of the Study:

• To evaluate the prognosis of multiple myeloma patients double-refractory to primary induction therapy.
• To determine the efficacy of autologous stem cell transplantation (ASCT) in this patient cohort.

Main Methods:

• Retrospective analysis of 85 patients with double-refractory multiple myeloma.
• Comparison of overall response rates (ORR) and progression-free survival (PFS) based on treatment strategies (ASCT vs. conventional therapies).

Main Results:

• Overall response rate (ORR) after second-line therapy was 51%.
• Patients undergoing ASCT showed superior ORR (62%) compared to conventional therapies (31%).
• ASCT performed immediately after first-line therapy yielded the highest ORR (91%) and was an independent predictor of improved PFS.

Conclusions:

• Primary refractory multiple myeloma patients benefit significantly from ASCT.
• Early ASCT, ideally after first-line induction, is associated with superior outcomes in refractory MM.