Myeloma Patients Can Still Respond to ASCT Past Assessment Times

Patients with multiple myeloma who undergo autologous stem cell transplantation (ASCT) can have a continued response to the treatment beyond the typical disease assessment at 100 days and should consider it in post-transplant treatments, says a new study.

According to study author Shaji K. Kumar, MD, of the division of hematology at the Mayo Clinic:

The fact that responses after stem cell transplant continue to improve over time has been observed for a long time ... [This] is important when interpreting data from single-arm trials looking at post-transplant therapies, in order to get a better sense of what the additional therapy provided over and above what would have happened in due course of time after a transplant.

Improved Responses Post-Transplant

Their findings, reported in the journal Blood, derived from analyzing outcomes in 430 patients with multiple myeloma treated with ASCT. Treatment for all patients began within one year of diagnosis. No patients had achieved complete remission 100 days post-transplant.

Said Kumar:

Nearly a third of the patients had improvement in their responses beyond the 100 day mark, which is typically used for assessing response to transplant. In addition, we found that patients with this continued response did better overall, suggesting biological differences.

At evaluation:

• 39 percent of patients had a continued response to treatment at a median of 9.4 months post-transplantation.
• Patients who continued to respond were found to have a longer progression-free survival than patients who did not (35 months v. 13 months).
• Continued responders had longer time to next therapy (43 months v. 16 months).
• Continued responders also had a longer overall survival (96 months v. 57 months) compared to patients without continued response.

In conclusion, the authors wrote:

Utilizing the day 100 response assessment for treatment decisions may be premature in patients who were going to have a continued response without further therapy.

Source: Mayo Clinic