Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma
Multiple myeloma (MM) remains as an incurable disease and, although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative approach, most patients ultimately relapse, and their treatment remains challenging. Because allo-HSCT can modify not only the biology of the d...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de documento: | artigo |
| Data de publicação: | 2019 |
| País: | España |
| Recursos: | Universitat Autònoma de Barcelona |
| Repositório: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglês |
| OAI Identifier: | oai:ddd.uab.cat:236897 |
| Acesso em linha: | https://ddd.uab.cat/record/236897 https://dx.doi.org/urn:doi:10.1016/j.bbmt.2019.04.026 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Allo-HSCT Allogeneic hematopoietic stem cell transplantation Immunomodulatory drug Multiple myeloma Proteasome inhibitor |
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oai:ddd.uab.cat:236897 |
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España |
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| dc.title.none.fl_str_mv |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma |
| title |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma |
| spellingShingle |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma López Corral, Lucia|||0000-0003-1908-5596 Allo-HSCT Allogeneic hematopoietic stem cell transplantation Immunomodulatory drug Multiple myeloma Proteasome inhibitor |
| title_short |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma |
| title_full |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma |
| title_fullStr |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma |
| title_full_unstemmed |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma |
| title_sort |
Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma |
| dc.creator.none.fl_str_mv |
López Corral, Lucia|||0000-0003-1908-5596 Caballero Velazquez, Teresa|||0000-0001-7487-3793 López-Godino, Oriana Rosiñol, Laura|||0000-0002-2534-9239 Pérez-Vicente, Sabina Fernandez Aviles, Francesc|||0000-0003-3051-3926 Krsnik, Isabel|||0000-0002-2912-5072 Morillo, Daniel Heras, Inmaculada Morgades, Mireia|||0000-0003-0295-2534 Rifon, Jose|||0000-0002-1649-8478 Sampol, Antonia|||0000-0001-7465-6203 Iniesta, Francisca Ocio, Enrique M.|||0000-0002-5765-0085 Martin, Jesús Rovira Tarrats, Montserrat|||0000-0002-6403-3317 Cabero, Martín Castilla-Llorente, Cristina Ribera, Jose-Maria|||0000-0003-1042-6024 Torres-Juan, Marta Moraleda, José María|||0000-0001-9080-1466 Martinez, Carmen Vázquez, Alejandro Gutiérrez-García, Gonzalo|||0000-0003-4084-8279 Caballero, Dolores|||0000-0002-9544-9614 San Miguel, Jesús|||0000-0002-9183-4857 Mateos, M. V.|||0000-0003-2390-1218 Pérez-Simón, José Antonio|||0000-0003-3616-6101 |
| author |
López Corral, Lucia|||0000-0003-1908-5596 |
| author_facet |
López Corral, Lucia|||0000-0003-1908-5596 Caballero Velazquez, Teresa|||0000-0001-7487-3793 López-Godino, Oriana Rosiñol, Laura|||0000-0002-2534-9239 Pérez-Vicente, Sabina Fernandez Aviles, Francesc|||0000-0003-3051-3926 Krsnik, Isabel|||0000-0002-2912-5072 Morillo, Daniel Heras, Inmaculada Morgades, Mireia|||0000-0003-0295-2534 Rifon, Jose|||0000-0002-1649-8478 Sampol, Antonia|||0000-0001-7465-6203 Iniesta, Francisca Ocio, Enrique M.|||0000-0002-5765-0085 Martin, Jesús Rovira Tarrats, Montserrat|||0000-0002-6403-3317 Cabero, Martín Castilla-Llorente, Cristina Ribera, Jose-Maria|||0000-0003-1042-6024 Torres-Juan, Marta Moraleda, José María|||0000-0001-9080-1466 Martinez, Carmen Vázquez, Alejandro Gutiérrez-García, Gonzalo|||0000-0003-4084-8279 Caballero, Dolores|||0000-0002-9544-9614 San Miguel, Jesús|||0000-0002-9183-4857 Mateos, M. V.|||0000-0003-2390-1218 Pérez-Simón, José Antonio|||0000-0003-3616-6101 |
| author_role |
author |
| author2 |
Caballero Velazquez, Teresa|||0000-0001-7487-3793 López-Godino, Oriana Rosiñol, Laura|||0000-0002-2534-9239 Pérez-Vicente, Sabina Fernandez Aviles, Francesc|||0000-0003-3051-3926 Krsnik, Isabel|||0000-0002-2912-5072 Morillo, Daniel Heras, Inmaculada Morgades, Mireia|||0000-0003-0295-2534 Rifon, Jose|||0000-0002-1649-8478 Sampol, Antonia|||0000-0001-7465-6203 Iniesta, Francisca Ocio, Enrique M.|||0000-0002-5765-0085 Martin, Jesús Rovira Tarrats, Montserrat|||0000-0002-6403-3317 Cabero, Martín Castilla-Llorente, Cristina Ribera, Jose-Maria|||0000-0003-1042-6024 Torres-Juan, Marta Moraleda, José María|||0000-0001-9080-1466 Martinez, Carmen Vázquez, Alejandro Gutiérrez-García, Gonzalo|||0000-0003-4084-8279 Caballero, Dolores|||0000-0002-9544-9614 San Miguel, Jesús|||0000-0002-9183-4857 Mateos, M. V.|||0000-0003-2390-1218 Pérez-Simón, José Antonio|||0000-0003-3616-6101 |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Universitat Autònoma de Barcelona |
| dc.subject.none.fl_str_mv |
Allo-HSCT Allogeneic hematopoietic stem cell transplantation Immunomodulatory drug Multiple myeloma Proteasome inhibitor |
| topic |
Allo-HSCT Allogeneic hematopoietic stem cell transplantation Immunomodulatory drug Multiple myeloma Proteasome inhibitor |
| description |
Multiple myeloma (MM) remains as an incurable disease and, although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative approach, most patients ultimately relapse, and their treatment remains challenging. Because allo-HSCT can modify not only the biology of the disease, but also the immune system and the microenvironment, it can potentially enhance the response to rescue therapies. Information on the efficacy and safety of novel drugs in patients relapsing after allo-HSCT is lacking, however. The objectives of this study were to evaluate the efficacy and toxicity of rescue therapies in patients with MM who relapsed after allo-HSCT, as well as to compare their efficacy before and after allo-HSCT. This retrospective multicenter study included 126 consecutive patients with MM who underwent allo-HSCT between 2000 and 2013 at 8 Spanish centers. All patients engrafted. The incidence of grade II-IV acute graft-versus-host disease (GVHD) was 47%, and nonrelapse mortality within the first 100 days post-transplantation was 13%. After a median follow-up of 92 months, overall survival (OS) was 51% at 2 years and 43% at 5 years. The median progression-free survival after allo-HSCT was 7 months, whereas the median OS after relapse was 33 months. Patients relapsing in the first 6 months after transplantation had a dismal prognosis compared with those who relapsed later (median OS, 11 months versus 120 months; P <.001). The absence of chronic GVHD was associated with reduced OS after relapse (hazard ratio, 3.44; P <.001). Most patients responded to rescue therapies, including proteasome inhibitors (PIs; 62%) and immunomodulatory drugs (IMiDs; 77%), with a good toxicity profile. An in-depth evaluation, including the type and intensity of PI- and IMiD-based combinations used before and after allo-HSCT, showed that the overall response rate and duration of response after allo-HSCT were similar to those seen in the pretransplantation period. Patients with MM who relapse after allo-HSCT should be considered candidates for therapy with new drugs, which can achieve similar response rates with similar durability as seen in the pretransplantation period. This pattern does not follow the usual course of the disease outside the transplantation setting, where response rates and time to progression decreases with each consecutive line of treatment. |
| publishDate |
2019 |
| dc.date.none.fl_str_mv |
2 2019-01-01 2019 2019-01-01 |
| dc.type.none.fl_str_mv |
Article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://ddd.uab.cat/record/236897 https://dx.doi.org/urn:doi:10.1016/j.bbmt.2019.04.026 |
| url |
https://ddd.uab.cat/record/236897 https://dx.doi.org/urn:doi:10.1016/j.bbmt.2019.04.026 |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.rights.openaire.fl_str_mv |
info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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application/pdf |
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reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona |
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Universitat Autònoma de Barcelona |
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Dipòsit Digital de Documents de la UAB |
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Dipòsit Digital de Documents de la UAB |
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1869420044442664960 |
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Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple MyelomaLópez Corral, Lucia|||0000-0003-1908-5596Caballero Velazquez, Teresa|||0000-0001-7487-3793López-Godino, OrianaRosiñol, Laura|||0000-0002-2534-9239Pérez-Vicente, SabinaFernandez Aviles, Francesc|||0000-0003-3051-3926Krsnik, Isabel|||0000-0002-2912-5072Morillo, DanielHeras, InmaculadaMorgades, Mireia|||0000-0003-0295-2534Rifon, Jose|||0000-0002-1649-8478Sampol, Antonia|||0000-0001-7465-6203Iniesta, FranciscaOcio, Enrique M.|||0000-0002-5765-0085Martin, JesúsRovira Tarrats, Montserrat|||0000-0002-6403-3317Cabero, MartínCastilla-Llorente, CristinaRibera, Jose-Maria|||0000-0003-1042-6024Torres-Juan, MartaMoraleda, José María|||0000-0001-9080-1466Martinez, CarmenVázquez, AlejandroGutiérrez-García, Gonzalo|||0000-0003-4084-8279Caballero, Dolores|||0000-0002-9544-9614San Miguel, Jesús|||0000-0002-9183-4857Mateos, M. V.|||0000-0003-2390-1218Pérez-Simón, José Antonio|||0000-0003-3616-6101Allo-HSCTAllogeneic hematopoietic stem cell transplantationImmunomodulatory drugMultiple myelomaProteasome inhibitorMultiple myeloma (MM) remains as an incurable disease and, although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative approach, most patients ultimately relapse, and their treatment remains challenging. Because allo-HSCT can modify not only the biology of the disease, but also the immune system and the microenvironment, it can potentially enhance the response to rescue therapies. Information on the efficacy and safety of novel drugs in patients relapsing after allo-HSCT is lacking, however. The objectives of this study were to evaluate the efficacy and toxicity of rescue therapies in patients with MM who relapsed after allo-HSCT, as well as to compare their efficacy before and after allo-HSCT. This retrospective multicenter study included 126 consecutive patients with MM who underwent allo-HSCT between 2000 and 2013 at 8 Spanish centers. All patients engrafted. The incidence of grade II-IV acute graft-versus-host disease (GVHD) was 47%, and nonrelapse mortality within the first 100 days post-transplantation was 13%. After a median follow-up of 92 months, overall survival (OS) was 51% at 2 years and 43% at 5 years. The median progression-free survival after allo-HSCT was 7 months, whereas the median OS after relapse was 33 months. Patients relapsing in the first 6 months after transplantation had a dismal prognosis compared with those who relapsed later (median OS, 11 months versus 120 months; P <.001). The absence of chronic GVHD was associated with reduced OS after relapse (hazard ratio, 3.44; P <.001). Most patients responded to rescue therapies, including proteasome inhibitors (PIs; 62%) and immunomodulatory drugs (IMiDs; 77%), with a good toxicity profile. An in-depth evaluation, including the type and intensity of PI- and IMiD-based combinations used before and after allo-HSCT, showed that the overall response rate and duration of response after allo-HSCT were similar to those seen in the pretransplantation period. Patients with MM who relapse after allo-HSCT should be considered candidates for therapy with new drugs, which can achieve similar response rates with similar durability as seen in the pretransplantation period. This pattern does not follow the usual course of the disease outside the transplantation setting, where response rates and time to progression decreases with each consecutive line of treatment.Universitat Autònoma de Barcelona 22019-01-0120192019-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/236897https://dx.doi.org/urn:doi:10.1016/j.bbmt.2019.04.026reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2368972026-06-06T12:50:31Z |
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15,198674 |