Complete Response After Stem Cell Transplant For Myeloma Indicates Best Prognosis
Published: May 31, 2011 4:49 pm
Spanish researchers recently published long-term follow-up results confirming that a complete response following stem cell transplantation in multiple myeloma patients increases overall and progression-free survival compared to a very good or partial response.
Treatment with high-dose chemotherapy followed by stem cell transplantation is a standard therapeutic approach for younger, newly diagnosed multiple myeloma patients. There has been some debate among researchers, however, as to whether the quality of response following transplantation can predict patient outcome.
In 2000, the same group of researchers published results demonstrating that complete response should be an important goal of stem cell transplantation as it improved overall survival rates in multiple myeloma patients (see the 2000 study). The goal of the current study was to confirm these results after a longer follow-up period.
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The researchers studied 344 multiple myeloma patients who had received stem cell transplants between 1989 and 1998. All 344 patients were included in the original 2000 study. When the follow-up analysis was done in February 2010, updated information was available for 322 of these patients.
Based on the long-term follow-up study, the average progression-free survival period for complete responders following transplantation was 47 months, compared to 30 months for near complete responders, 27 months for very good partial responders, and 23 months for partial responders. At a 12 year follow-up point, 28 percent of complete responders remained progression-free, while 19 percent of near complete responders, 10 percent of very good partial responders, and 11 percent of partial responders remained progression-free.
Overall survival was 91 months for patients achieving a complete response, 56 months, 55 months, and 43 months for patients achieving a near complete, very good partial, and partial response, respectively. At a follow up of 12 years, the overall survival rates were 35 percent for complete responders, 22 percent for near complete responders, and 16 percent for both very good and partial responders.
Based on their results, the researchers concluded that those patients who achieved a complete response following transplantation had a significant survival advantage over those who did not achieve a complete response. Patients who received a near complete response, very good partial response, or partial response were considered to have similar progression-free and overall survival times.
The study also found that a plateau in the progression-free survival and overall survival times occurred 11 years after transplantation. In other words, the number of patients who progressed or died over time leveled off around 11 years, such that those patients who were still alive and still in remission at 11 years were likely to continue living in remission.
A total of 35 percent of patients who achieved a complete response reached plateau, and all patients still in complete response at plateau had not relapsed in an average of five years beyond plateau. The study authors suggested this indicates that these patients may be cured.
Of the patients who achieved a near complete, very good partial, or partial response, 11 percent reached plateau. Two patients in this group relapsed since the plateau.
For more information, see the study published in Blood (abstract).
- New Response Type May Help Determine Multiple Myeloma Patients’ Prognoses
- Achieving Very Good Partial Response Indicates A Good Prognosis For Multiple Myeloma Patients, Study Finds
- Canadian Study Takes In-Depth Look At Second Stem Cell Transplants As Salvage Therapy
- Degree Of Complete Response After Transplant May Affect Survival In Myeloma
- Unresponsiveness To Revlimid Or Thalidomide Indicates Poor Response To Stem Cell Transplant, Study Finds