Salvage Autologous Stem Cell Transplantation Outcomes and The Use of Maintenance in Relapsed Multiple Myeloma: Real world evidence from the Canadian Myeloma Research Group Database.

BACKGROUND

Salvage autologous stem cell transplantation (ASCT2) remains a treatment option for selected patients with relapsed multiple myeloma (MM). In this multicenter study, we conducted a retrospective analysis using the Canadian Myeloma Research Group (CMRG) database to evaluate real-world outcomes of ASCT2 in the maintenance era.

PATIENTS AND

METHODS

Three hundred and fifty-two patients underwent ASCT2 following progression after ASCT1 between 2012 and 2021. Progression-free survival (PFS), overall survival (OS), depth of response, and the impact of maintenance therapy after ASCT2 were assessed, with further stratification based on maintenance use after ASCT1.

RESULTS

Our analysis demonstrated that post-ASCT2 maintenance therapy was associated with improved outcomes, particularly in patients who had also received maintenance after ASCT1 (25.2 months (95% CI, 20.8-39.6) versus 11.6 months (95% CI, 8.51-18.8)). In patients receiving lenalidomide maintenance after ASCT1, a remission lasting less than 3 years represented a high risk group with poor outcomes with an ASCT2.

CONCLUSION

While novel agents continue to expand treatment options, ASCT2 remains a viable therapeutic strategy in appropriately selected patients, especially those with durable responses to prior therapy.