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Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome

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Published on: October 3, 2018

Time to progression predicts outcome of patients with multiple myeloma that can be influenced by autologous

Yanhua Yue^1,2, Yingjie Miao², Yifang Zhou²

¹Department of Hematology, The First People's Hospital of Changzhou, Changzhou Medical Center, Nanjing Medical University, Changzhou, People's Republic of China.

Hematology (Amsterdam, Netherlands)

|January 3, 2025

Summary

Earlier time to progression (TTP) after remission in multiple myeloma (MM) indicates a worse prognosis. Autologous hematopoietic stem cell transplantation (ASCT) after progression improves survival outcomes for these patients.

Keywords:

Multiple myeloma chemotherapy outcome time to progression ‌autologous hematopoietic stem cell transplantation ‌first remission ‌myeloma progression ‌post-progression treatment

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Area of Science:

Hematology
Oncology
Clinical Research

Background:

Limited understanding exists regarding the prognostic significance of time to progression (TTP) after first remission in multiple myeloma (MM).
Assessing TTP is crucial for predicting patient outcomes and guiding treatment strategies in MM.

Purpose of the Study:

To investigate the prognostic value of TTP after first remission in multiple myeloma (MM).
To evaluate the impact of TTP on overall survival (OS) and identify optimal post-progression treatment strategies.

Main Methods:

Retrospective analysis of clinical data from 209 multiple myeloma (MM) patients.
Patients were stratified into subgroups based on TTP after first remission (≤ 6 months, ≤ 12 months, ≤ 24 months, > 24 months, 6-12 months, and 12-24 months).
Overall survival (OS) and progression-free survival (PFS) were compared across TTP subgroups, and the impact of autologous hematopoietic stem cell transplantation (ASCT) after progression was analyzed.

Main Results:

Patients with shorter TTP (≤ 12 months) had significantly shorter median OS and OS-1 compared to those with longer TTP (≤ 24 months).
A TTP of ≤ 6 months was associated with worse OS and OS-1 compared to 6-12 months TTP.
Patients undergoing ASCT after progression showed a survival advantage over those receiving chemotherapy, particularly for those progressing within 12 or 24 months.
Multivariable analysis confirmed TTP as an independent predictor of OS in MM.

Conclusions:

Earlier disease progression within 12 months after remission in MM patients is linked to a poorer prognosis.
Autologous hematopoietic stem cell transplantation (ASCT) following disease progression can enhance survival outcomes for MM patients.