Improvement in Post-Autologous Stem Cell Transplant Survival of Multiple Myeloma Patients: A Long-Term Institutional Experience

SIMPLE SUMMARY: The outcomes of patients with multiple myeloma have significantly improved over the years, following autologous stem cell transplant and the introduction of novel agents. In this study, we performed a retrospective survival analysis on newly diagnosed MM patients receiving ASCT from 1992–2016 at the Ohio State University. We observed that newly diagnosed MM patients’ survival and responses to standard of care treatment have improved dramatically since 1992, primarily due to the inclusion of novel and maintenance therapies. There was an improvement in patient remission status, PFS, and OS, suggesting that evolving standards of therapy for MM are enhancing patient outcomes. These findings highlight the importance for newer interventions to build on prior successes. ABSTRACT: Multiple myeloma (MM) represents 1.8% of all new cancer cases in the U.S. While not curable, advances in treatment, including autologous stem cell transplant (ASCT) and maintenance therapy, have dramatically improved progression-free survival (PFS) and overall survival (OS). We performed a retrospective survival analysis on newly diagnosed MM (NDMM) patients receiving ASCT from 1992–2016 at the Ohio State University. A total of 1001 consecutive NDMM patients were eligible. Patients were split into five groups based on historic changes in novel agents for the treatment of MM. Across the years (1992–2016), there was a statistically significant improvement in both PFS (p < 0.01) and OS (p < 0.01). Significant improvements in both PFS and OS were seen in patients ≤65 years (p < 0.001 and p = 0.002) and >65 years old (p < 0.001 and p = 0.001), respectively. Improved PFS and OS were seen in both standard-risk (p < 0.001 and p < 0.001) and high-risk patients (p < 0.001 and p = 0.019). The post-transplant response showed statistically significant improvement across the years (p < 0.01). Survival rates for NDMM patients have significantly improved primarily due to the inclusion of novel therapies and post-ASCT maintenance.