Impact of autologous transplantation in multiple myeloma patients with t(11;14): a propensity-score matched analysis

Purpose: Multiple myeloma (MM) patients with t(11;14) have been considered to have standard-risk disease. However, several recent reports have shown contradictory results. We identified 95 MM patients with t(11;14) on Fluorescence In Situ Hybridization (FISH) studies, who underwent upfront autologous hematopoietic stem cell transplant (auto-HCT) at our center. We compared their outcome with a group of standard-risk MM patients who had diploid cytogenetics by both conventional cytogenetics (CC) and FISH (n=287). Experimental Design: To reduce the bias between the groups, we performed a 1:1 propensity score matching technique for analysis. A total of 160 patients, 80 in each group, were identified. Results: Patients in t(11;14) group had a post auto-HCT overall response rate (ORR) of 97.5%(78/80), compared to 100% (80/80) in the standard-risk control group (p=0.50). CR rate in the t(11;14) group was 35%(28/80), compared to 45%(36/80) in the standard-risk control group (p=0.26). The four-year PFS rates were 40.8% (95% CI: 29.6%-56.1%) and 51.1% (95%CI: 39.4%-66.3%) in the t(11;14) and standard-risk control groups, respectively (p=0.14). The four-year OS rates were 74.9% (95%CI: 63.3%-88.7%) and 88.3% (95%CI: 80.4%-97.0%) in the t(11;14) and standard-risk control groups, respectively(p=0.17). Also, patients with t(11;14) with concurrent cytogenetics had significantly poor PFS and OS compared to a propensity matched standard-risk control group. Conclusions: Our study confirms that t(11;14) MM undergoing upfront autologous transplantation had similar outcomes as MM patients with normal cytogenetic and FISH studies. Existence of additional genomic aberrations by CC or FISH was associated with a worse outcome.