دورية أكاديمية
أعرض في EDS

Risk factors of early disease progression and decreased survival for multiple myeloma patients after upfront autologous stem cell transplantation.

التفاصيل البيبلوغرافية
العنوان: Risk factors of early disease progression and decreased survival for multiple myeloma patients after upfront autologous stem cell transplantation.
المؤلفون: Hsu TL; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; Division of Holistic and Multidisciplinary Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Tsai CK; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Liu CY; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Yeh CM; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan., Lin FL; Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Hsiao LT; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Liu YC; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Chien SH; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Wang HY; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Ko PS; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Lin TA; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Chen WC; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Chen PM; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Liu JH; Section of Hematology and Oncology, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.; Institute of Biopharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Chong Hin Loon Memorial Cancer and Biotherapy Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan., Gau JP; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Liu CJ; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan. chiajenliu@gmail.com.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. chiajenliu@gmail.com.; Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. chiajenliu@gmail.com.; Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. chiajenliu@gmail.com.
المصدر: Annals of hematology [Ann Hematol] 2024 Aug; Vol. 103 (8), pp. 2893-2904. Date of Electronic Publication: 2024 Mar 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9107334 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0584 (Electronic) Linking ISSN: 09395555 NLM ISO Abbreviation: Ann Hematol Subsets: MEDLINE
أسماء مطبوعة: Publication: Berlin : Springer Verlag
Original Publication: Berlin ; New York : Springer International, c1991-
مواضيع طبية MeSH: Multiple Myeloma*/therapy , Multiple Myeloma*/mortality , Hematopoietic Stem Cell Transplantation*/adverse effects , Disease Progression* , Transplantation, Autologous*, Humans ; Female ; Male ; Middle Aged ; Aged ; Risk Factors ; Adult ; Retrospective Studies ; Survival Rate ; Autografts
مستخلص: Multiple myeloma (MM) stands as the second most prevalent hematological malignancy, constituting approximately 10% of all hematological malignancies. Current guidelines recommend upfront autologous stem cell transplantation (ASCT) for transplant-eligible MM patients. This study seeks to delineate factors influencing post-ASCT outcomes in MM patients. Our cohort comprised 150 MM patients from Taipei Veterans General Hospital, with progression-free survival (PFS) as the primary endpoint and overall survival (OS) as the secondary endpoint. A Cox proportional hazards model was employed to discern potential predictive factors for survival. ASCT age ≥ 65 (hazard ratio [HR] 1.94, 95% confidence interval [CI] 1.08-3.47) and the presence of extramedullary disease (HR 2.53, 95% CI 1.53-4.19) negatively impacted PFS. Conversely, treatment response ≥ VGPR before ASCT (HR 0.52, 95% CI 0.31-0.87) and total CD34 + cells collected ≥ 4 × 10 6 cells/kg on the first stem cell harvesting (HR 0.52, 95% CI 0.32-0.87) were positively associated with PFS. For OS, patients with ISS stage III (HR 2.06, 95% CI 1.05-4.04), the presence of extramedullary disease (HR 3.92, 95% CI 2.03-7.58), light chain ratio ≥ 100 before ASCT (HR 7.08, 95% CI 1.45-34.59), post-ASCT cytomegalovirus infection (HR 9.43, 95% CI 3.09-28.84), and a lower conditioning melphalan dose (< 140 mg/m 2 ; HR 2.75, 95% CI 1.23-6.17) experienced shorter OS. In contrast, post-ASCT day + 15 absolute monocyte counts (D15 AMC) > 500/µl (HR 0.36, 95% CI 0.17-0.79) and post-ASCT day + 15 platelet counts (D15 PLT) > 80,000/µl (HR 0.48, 95% CI 0.24-0.94) were correlated with improved OS. Significantly, early PLT and AMC recovery on day + 15 predicting longer OS represents a novel finding not previously reported. Other factors also align with previous studies. Our study provides real-world insights for post-ASCT outcome prediction beyond clinical trials.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Autologous hematopoietic stem cell transplantation; Maintenance therapy; Monocyte count; Multiple myeloma; Platelet count
تواريخ الأحداث: Date Created: 20240313 Date Completed: 20240728 Latest Revision: 20240730
رمز التحديث: 20240730
مُعرف محوري في PubMed: PMC11283432
DOI: 10.1007/s00277-024-05641-y
PMID: 38472362
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-0584
DOI:10.1007/s00277-024-05641-y