Patterns of relapse and progression in multiple myeloma patients after auto-SCT: Implications for patients' monitoring after transplantation Journal Article
| Authors: | Zamarin, D.; Giralt, S.; Landau, H.; Lendvai, N.; Lesokhin, A.; Chung, D.; Koehne, G.; Chimento, D.; Devlin, S. M.; Riedel, E.; Bhutani, M.; Babu, D.; Hassoun, H. |
| Article Title: | Patterns of relapse and progression in multiple myeloma patients after auto-SCT: Implications for patients' monitoring after transplantation |
| Abstract: | Auto-SCT (ASCT) is widely used in first-line treatment of multiple myeloma (MM). However, most patients eventually relapse or have progression of disease (R/POD). Although precise knowledge of R/POD patterns would be important to generate evidence-based surveillance recommendations after ASCT, such data is limited in the literature, especially after introduction of the free light chain assay (FLCA). This retrospective study examined the patterns of R/POD after first-line ASCT in 273 patients, using established criteria. At the time of R/POD, only 2% of patients had no associated serological evidence of R/POD. A total of 85% had asymptomatic R/POD, first detected by serological testing, whereas 15% had symptomatic R/POD with aggressive disease, early R/POD and short survival, with poor cytogenetics and younger age identified as risk factors. Although occult skeletal lesions were found in 40% of asymptomatic patients tested following serological R/POD, yearly skeletal surveys and urine testing were poor at heralding R/POD. We found a consistent association between paraprotein types at diagnosis and R/POD, allowing informed recommendations for appropriate serological monitoring and propose a new needed criterion using FLCA for patients relapsing by FLC only. Our findings provide important evidence-based recommendations that strengthen current monitoring guidelines after first-line ASCT in MM. © 2013 Macmillan Publishers Limited. All rights reserved. |
| Keywords: | multiple myeloma; relapse; autologous transplantation; free light chain assay |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 48 |
| Issue: | 3 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2013-03-01 |
| Start Page: | 419 |
| End Page: | 424 |
| Language: | English |
| DOI: | 10.1038/bmt.2012.151 |
| PROVIDER: | scopus |
| PMCID: | PMC3594539 |
| PUBMED: | 22890289 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 April 2013" - "CODEN: BMTRE" - "Source: Scopus" |
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