Clinical Predictors of Long-Term Survival in Newly Diagnosed Transplant Eligible Multiple Myeloma – an IMWG Research Project

This study examines the clinical predictors of long-term survival in multiple myeloma patients eligible for high-dose chemotherapy and autologous stem cell transplantation (HDM-ASCT). ​ The analysis reveals that achieving complete response (CR) within the first year of diagnosis is associated with superior progression-free survival (PFS) and overall survival (OS). ​ Older age at diagnosis and higher disease burden, as indicated by bone marrow plasmacytosis, anemia, and serum creatinine levels, are negatively correlated with long-term survival (>10 years). ​ The study also identifies several clinical variables at diagnosis that impact long-term survival, including age over 65 years, IgA isotype, low albumin, elevated beta 2 microglobulin, high serum creatinine levels, low hemoglobin levels, and low platelet count. ​ The cure fraction for the study population is found to be 14.37%, indicating the proportion of patients who achieved or exceeded expected survival compared to the general population. ​ The relative survival for the cohort is approximately 0.9. ​

Important points:

1. Achieving CR within the first year of diagnosis is associated with better PFS and OS. ​
2. Older age and higher disease burden are negatively correlated with long-term survival. ​
3. Clinical variables at diagnosis, such as age, IgA isotype, albumin levels, beta 2 microglobulin levels, serum creatinine levels, hemoglobin levels, and platelet count, impact long-term survival. ​
4. The cure fraction for the study population is 14.37%. ​
5. The relative survival for the cohort is approximately 0.9. ​
6. Thalidomide treatment enhances the benefit of achieving CR. ​
7. Age over 65 years does not impact the ability to achieve CR. ​

Authors:

Usmani SZ, Hoering A, Cavo M, Miguel JS, Goldschimdt H, Hajek R, Turesson I, Lahuerta JJ, Attal M, Barlogie B, Lee JH, Kumar S, Lenhoff S, Morgan G, Rajkumar SV, Durie BGM, Moreau P.

Citation:

Usmani et al. Blood Cancer Journal ( 2018) 8:123
DOI 10.1038/s41408-018-0155-7