In the era of Bortezomib-based Induction, intensification of Melphalan-based conditioning with Bortezomib does not improve Survival Outcomes in newly diagnosed Multiple Myeloma: a study from the Chronic Malignancies Working Party of the EBMT. - Université de Lille Accéder directement au contenu
Article Dans Une Revue Bone Marrow Transplantation Année : 2024

In the era of Bortezomib-based Induction, intensification of Melphalan-based conditioning with Bortezomib does not improve Survival Outcomes in newly diagnosed Multiple Myeloma: a study from the Chronic Malignancies Working Party of the EBMT.

Meral Beksac
  • Fonction : Auteur
Diderik-Jan Eikema
  • Fonction : Auteur
Linda Koster
  • Fonction : Auteur
Cyrille Hulin
  • Fonction : Auteur
Xavier Poiré
  • Fonction : Auteur
Rose-Marie Hamladji
  • Fonction : Auteur
Tomasz Gromek
  • Fonction : Auteur
Ali Bazarbachi
  • Fonction : Auteur
Zubeyde Nur Ozkurt
  • Fonction : Auteur
Thomas Pabst
  • Fonction : Auteur
Tarek Ben Othman
  • Fonction : Auteur
Jürgen Finke
  • Fonction : Auteur
Olga Pirogova
  • Fonction : Auteur
Depei Wu
  • Fonction : Auteur
Amjad Hayat
  • Fonction : Auteur
Inken Hilgendorf
  • Fonction : Auteur
Eleni Tholouli
  • Fonction : Auteur
Liesbeth C. de Wreede
  • Fonction : Auteur
Stefan Schönland
  • Fonction : Auteur
Laurent Garderet
  • Fonction : Auteur
Joanna Drozd-Sokolowska
  • Fonction : Auteur
Kavita Raj
  • Fonction : Auteur
Patrick J. Hayden
  • Fonction : Auteur
Donal P. Mclornan
  • Fonction : Auteur

Résumé

Bortezomib (Vel)- Melphalan 200 mg/m2 (Mel200) (Vel-Mel) has been utilised to intensify conditioning in autologous hematopoietic stem cell transplantation (AHCT) for multiple myeloma (MM). This EBMT registry-based study compared Vel-Mel with Mel200 during upfront AHCT. Between 2010 and 2017, MM patients who received Vel-Mel (n = 292) conditioning were compared with 4,096 Mel200 patients in the same 58 centres. Pre-AHCT, compared to Mel200 patients, Vel-Mel patients had similar International Staging System (ISS) scores and cytogenetic risk profiles; a similar proportion had received bortezomib-based induction (85% and 87.3%, respectively) though they were younger with a better performance status. Vel-Mel patients were more likely to achieve CR post-induction (40.6% vs 20.3%, p < 0.001) and by day 100 of AHCT (CR/VGPR: 70.2 % vs. 57.2%, p < 0.001). There was no difference in 3-year PFS (49% vs 46%, p = 0.06) or early post-AHCT mortality. In multivariable analysis, Vel-Mel associated with inferior PFS (HR: 1.69 (1.27–2.25, p < 0.001) and OS (HR:1.46 (1.14–1.86,p = 0.002), similar to negative effects on PFS of advanced ISS (HR:1.56 (1.33–1.83, p < 0.001), high-risk cytogenetics (HR:1.43(1.18–1.74, p < 0.001) and poor post-induction response(<=PR)(HR: 1.43(1.25–1.62, p < 0.001) Overall, despite superior pre- and post-AHCT responses, there was no improvement in PFS or OS following Vel-Mel. This data supports the findings of the smaller prospective IFM study.
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hal-04637023 , version 1 (05-07-2024)

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Meral Beksac, Diderik-Jan Eikema, Linda Koster, Cyrille Hulin, Xavier Poiré, et al.. In the era of Bortezomib-based Induction, intensification of Melphalan-based conditioning with Bortezomib does not improve Survival Outcomes in newly diagnosed Multiple Myeloma: a study from the Chronic Malignancies Working Party of the EBMT.. Bone Marrow Transplantation, 2024, Bone Marrow Transplantation, 59, pp.526-533. ⟨10.1038/s41409-023-02160-8⟩. ⟨hal-04637023⟩

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