Evaluation of clinical efficacy and prognostic factors in multiple myeloma patients treated with auto-HSCT: A single-center real-world study

Zhuoga Pingcuo; Jianli Wang; Yan XU; Wanhong Zhao; Pengyu Zhang; Jie Liu; Bo Lei; Aili HE

Return

Evaluation of clinical efficacy and prognostic factors in multiple myeloma patients treated with auto-HSCT: A single-center real-world study

VernacularTitle:自体造血干细胞移植治疗多发性骨髓瘤的疗效评价及影响因素：单中心真实世界研究
Author: Zhuoga PINGCUO ^{1
,

2} ; Jianli WANG ¹ ; Yan XU ¹ ; Wanhong ZHAO ¹ ; Pengyu ZHANG ¹ ; Jie LIU ¹ ; Bo LEI ¹ ; Aili HE ¹
Author Information

1. Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004
2. Department of Rheumatology and Hematology, Tibet Autonomous Region People’s Hospital, Lhasa 850000, China
Publication Type:Journal Article
Keywords: autologous hematopoietic stem cell transplantation; multiple myeloma; clinical efficacy; prognostic factor
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(3):452-459
CountryChina
Language:Chinese
Abstract: 【Objective】 To evaluate the clinical efficacy and prognostic factors in multiple myeloma (MM) patients treated with autologous hematopoietic stem cell transplantation (auto-HSCT). 【Methods】 The clinical data of 155 MM patients newly diagnosed and suitable for transplantation in our hospital from 2014 to 2021 were retrospectively analyzed. They were divided into auto-HSCT group and non-auto-HSCT group according to the treatment mode. The clinical efficacy, overall survival (OS) and progression-free survival (PFS) of the two groups were compared. Furthermore, the prognostic factors of auto-HSCT group were analyzed. 【Results】 ① There were 51 patients in auto-HSCT group and 104 patients in non-auto-HSCT group. There was no statistical difference in baseline characteristics except age between the two groups. ② Hematopoietic reconstruction was achieved in all patients in auto-HSCT group, and no transplantation-related mortality was found. ③ The clinical efficacy of pre-and post-transplantation was compared in auto-HSCT group. sCR/CR rate was significantly increased after transplantation (P=0.041). The effective remission rate (≥VGPR) was also higher (P=0.05). As for the best efficacy, sCR/CR rate and effective remission rate were both significantly higher in auto-HSCT group than in non-auto-HSCT group (P=0.001). ④ In auto-HSCT group, by the end of follow-up, the median OS was not reached, the median PFS was 30.5 months, and 3-year OS and PFS was 87% and 40.3%, respectively. In non-auto-HSCT group, the median OS was 61 months, the median PFS was 21 months, and 3-year OS and PFS was 65.3% and 33.1%, respectively. It indicated that OS was significantly prolonged in auto-HSCT group (P=0.004). PFS was also prolonged but without significant difference (P=0.065). ⑤ Analysis of prognostic factors in auto-HSCT group showed that decreased PLT (P=0.038) and increased serum-adjusted calcium (P=0.017) were independent risk factors for OS, decreased PLT (P=0.005), female (P=0.018) and disease status of PR or worse before transplantation (P=0.012) were independent risk factors for PFS. 【Conclusion】 Auto-HSCT can improve the remission rate, prolong OS in MM patients, and possibly prolong PFS. Increased serum-corrected calcium and decreased PLT are independent prognostic factors for OS in patients treated with auto-HSCT. Decreased PLT, female, and disease status of PR or worse before transplantation are independent prognostic factors for PFS.