The impact of ASCT on patients with newly diagnosed multiple myeloma who receive RVD induction

2013 
Objective: Lenalidomide-bortezomib-dexamethasone (RVD) is associated with a high-rate of response in newlydiagnosed multiple myeloma (MM). Autologous stem cell transplantation (ASCT) with high-dose melphalan conditioningis a standard of care in MM. The impact of ASCT following RVD induction is not known. This study evaluates the impactof ASCT following RVD induction therapy in MM. Methods: Using our center’s transplant database, we identified 60 patients with newly diagnosed MM who underwentRVD induction followed by ASCT in first response. We describe disease characteristics including International StagingSystem (ISS) stage and cytogenetics, pre- and post-ASCT response, as well as progression-free survival (PFS) from timeof ASCT. Results: The rate of paraprotein complete response prior to and following ASCT was 50% and 60%, respectively. Amongthe 30 patients who did not achieve a paraprotein CR pre-ASCT, 14 (47%) patients had improved response post-transplant.At a median follow-up of 23 months, 90% (90% CI: [81%, 95%]) of the patients were alive without progression 12 monthsafter transplant. Conclusion: ASCT improves the rate of CR in patients with newly diagnosed MM who receive RVD induction therapy.
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