To examine improvements in long-term survival, we followed 4329 patients with newly diagnosed MM treated with autologous stem cell transplantation (ASCT) at the University of Arkansas for Medical Sciences from 1989 through 2018. However, improvements in treatments has raised the possibility that MM might be functionally curable. Traditionally, MM is considered an incurable disease, with most patients eventually relapsing. ![]() doi: 10.1056/NEJMoa1611750.As multiple myeloma (MM) treatments evolve, frequent updates are required to monitor the long-term effect of changes in approach. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. Progress and Paradigms in Multiple Myeloma. Combination of International Scoring System 3, high lactate dehydrogenase, and t(4 14) and/or del(17p) identifies patients with multiple myeloma (MM) treated with front-line autologous stem-cell transplantation at high risk of early MM progression-related death. Moreau P., Cavo M., Sonneveld P., Rosinol L., Attal M., Pezzi A., Goldschmidt H., Lahuerta J.J., Marit G., Palumbo A., et al. ![]() International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Rajkumar S.V., Dimopoulos M.A., Palumbo A., Blade J., Merlini G., Mateos M.V., Kumar S., Hillengass J., Kastritis E., Richardson P., et al. International Myeloma Working Group Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Therefore, in addition to the depth of response, the recovery of polyclonal Ig after ASCT is a useful indicator especially for long-term outcome and might be considered to prevent overtreatment with maintenance therapy in transplanted patients with MM.Īutologous stem cell transplantation immunoglobulin recovery multiple myeloma. ![]() The survival benefits of Ig recovery were similarly observed in ≥CR patients (median OS, not reached vs 80.5 months, p = 0.061) and non-CR patients (median OS, not reached vs 53.2 months, p = 0.00016). The patients with Ig recovery exhibited a significantly better progression-free survival (PFS, median, 46.8 vs 26.7 months, p = 0.0071) and overall survival (OS, median, not reached vs 65.3 months, p < 0.00001) compared with those without Ig recovery. Among 50 patients, 26 patients showed polyclonal Ig recovery 14 patients were in ≥complete response (CR) and 12 remained in non-CR after ASCT. The recovery of polyclonal Ig was defined as normalization of all values of serum IgG, IgA, and IgM 1 year after ASCT. We retrospectively analyzed multiple myeloma (MM) patients who underwent autologous stem cell transplantation (ASCT) without maintenance therapy to assess the impact of recovery of normal immunoglobulin (Ig) on clinical outcomes.
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