Single versus tandem autologous stem-cell transplantation in patients with newly diagnosed multiple myeloma and high-risk cytogenetics. A retrospective, open-label study of the PETHEMA/Spanish Myeloma Group (GEM)

Abstract

Tandem ASCT has been suggested as a valid approach to improve the prognosis of patients with MM and HR cytogenetic. In this observational, retrospective study, 213 patients with newly diagnosed MM and HR cytogenetic in 35 hospitals from the Spanish Myeloma Group underwent single or tandem ASCT between January 2015 and December 2019 after induction with VTD/VRD. HR cytogenetic was defined as having ≥1 of the following: del17p, t(4;14), t(14;16) or gain 1q21. More patients in the tandem group had R-ISS 3 and >1 cytogenetic abnormality at diagnosis. With a median follow-up of 31 months (range, 10–82), PFS after single ASCT was 41 months versus 48 months with tandem ASCT (p = 0.33). PFS in patients with del17p undergoing single ASCT was 41 months, while 52% of patients undergoing tandem ASCT were alive and disease free at 48 months. In conclusion, tandem ASCT partly overcomes the bad prognosis of HR cytogenetic.

Keywords:

• Multiple myeloma
• autologous stem cell transplantation
• high-risk cytogenetics
• tandem transplantation

Acknowledgments

We thank the following colleagues and institutions who provided assistance in the data collect for this research: Ana Serrano¹, Ana López², Carlos Aguilar³, M^a Belen Iñigo⁴, Dunia De Miguel⁵, Anna Sureda⁶, Alicia Roldán⁷, Aránzazu Garcia⁸, M^a Cristina Moragues⁹, Julio Davila¹⁰, Erik de Cabo¹¹, M^a José Moreno¹², María Casanova¹³, M^a Elena Ruiz¹⁴.

¹Complejo Hospitalario Universitario de Albacete, Albacete, Spain; ²Hematology Department, Hospital Universitario La Paz, Madrid, Spain; ³Hematology Department, Hospital Santa Bárbara, Soria, Spain; ⁴Hematology Department, Hospital Clínico San Carlos, Madrid, Spain; ⁵Hematology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain; ⁶Hematology Department, Hospital Durán i Reynals (ICO l'Hospitalet), Barcelona, Spain; Hematology Department, Hospital Universitario Infanta Sofia, Madrid, Spain; ⁸Hematology Department, Hospital General de Segovia, Segovia, Spain; ⁹Hematology Department, Hospital Comarcal Francesc de Borja, Gandia, Spain; ¹⁰Hematology Department, Complejo Asistencial de Ávila, Ávila, Spain; ¹¹Hematology Department, Hospital Universitario El Bierzo, Ponferrada, Spain; ¹²Hematology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; ¹³Hematology Department, Hospital Costa del Sol, Marbella, Spain; ¹⁴Hematology Department, Hospital Universitario del Tajo, Aranjuez, Spain.

Disclosure statement

No potential conflict of interest was reported by the author(s).