Table 5 Selected studies using salvage ASCT or Allo-SCT in the treatment of relapsed/refractory multiple myeloma
Clinical study | N | Efficacy post-ASCT2 | Post-ASCT2 TRM incidence |
---|---|---|---|
ASCT | |||
Cook G et al.59 | 106 case-matched pairsa,b,c (ASCT2 vs conventional chemotherapy) | ORR: 64% 4-year OS rate: 32% vs 22% (P<0.001) | Within 100 days: 7% 1 year: 7% 5 years: 12% |
Gonsalves WI et al.60 | 98a,b (ASCT2 after ASCT1 performed between 1994 and 2009) | ORR: 86% Median PFS: 10.3 months Median OS: 33 months | 4% |
Jimenez-Zepeda et al.61 | 81a,b (ASCT2 performed between 1992 and 2009) | ORR, day 100: 97% Median PFS: 16.4 months Median OS: 53 months | Within 100 days: 2.6% |
Lemieux E et al.62 | 81b,d (HDT + ASCT2 performed between 1995 and 2009 after frontline or tandem ASCT) | ORR: 93% Median PFS: 18 months Median OS: 4 years | 0 |
Michaelis LC et al.63 | 187a,b,c (ASCT2 performed between 1995 and 2008) | 1-, 3- and 5-year respective PFS rates: 47, 13 and 5% 1-, 3- and 5-year respective OS rates: 83, 46 and 29% | 1 year: 2% 3 years: 4% |
Morris C et al.64 | 7452b,c,e (ASCT2 after ASCT1 performed between 1993 and 2002) n=2655 (planned ASCT2) n=4797 (unplanned ASCT2) | Median OS: 61 months (planned) vs 51 months (unplanned) | No ASCT2 before relapse/TRM: HR, 1.00 0–6 months to ASCT2: HR, 3.69 (P<0.001) 6–12 months to ASCT2: HR, 2.97 (P<0.001) >12 months to ASCT2: HR, 11.30 (P<0.001) |
Sellner L et al.66 | 200b,e (ASCT2 after ASCT1 and HDT + melphalan reinduction therapy between 1995 and 2010) | ORR, day 100: 80% Median PFS: 15.2 months Median OS: 42.3 months | Within 100 days: 3% |
Allo-SCT | |||
Bensinger W et al.75 | 80d (allo-SCT after HDT±modified TBI) | ORR: 59% 4.5-year PFS probability: 20% 4.5-year OS probability: 24% | Within 100 days: 44% |
Bjorkstrand BB et al.76 | 189 case-matched pairs (allo-SCT vs ASCT) | ORR: 86% vs 72% (ASCT vs allo-SCT; P=0.001) Median OS: 34 vs 18 months (ASCT vs allo-SCT; P=0.001) | 3 years: 41% vs 13% (allo-SCT vs ASCT; P=0.0001) |
Qazilbash MH et al.79 | 40f (Allo-SCT vs ASCT2 between 1992 and 2004) n=14 allo-SCT n=26 ASCT2 | ORR: 69% vs 64% Median PFS: 7.3 vs 6.8 months Median OS: 13 vs 29.5 months | Within 100 days: 11% vs 7% Overall: 27% vs 14% |
Mehta J et al.78 | 42 case-matched pairs (allo-SCT between 1992 and 2006 vs ASCT2) | ORR: 62% vs 81% (P=0.05) 3-year PFS probability: 31±10% vs 72±9% (allo-SCT vs ASCT2; P=0.03) 3-year OS probability: 54±8% vs 29±9% (ASCT2 vs allo-SCT; P=0.01) | 1-year probability: 43±8% vs 10±5% (allo-SCT vs ASCT2; P=0.0001) |
Efebera Y et al.80 | 51f (allo-SCT between 1996 and 2006) | 2-year PFS rate: 19% 2-year OS rate: 32% | 1 year: 25% |
Coman T et al.86 | 52b,d (Len after allo-SCT between 2006 and 2009) | ORR: 83% Median PFS: 18 months Median OS: 30.5 months | 4% |