title: Impact of pre-transplant bone marrow plasma cell percentage on post-transplant response and survival in newly diagnosed multiple myeloma.
abstract: We evaluated 1070 patients with newly diagnosed multiple myeloma, who completed a single line of induction therapy followed by autologous stem cell transplantation. Patients with pre-transplant <5% BMPC had a threefold likelihood of achieving stringent complete response (sCR) after transplant compared to those with BMPC ≥5% (45.6% vs. 16.3%; p < 0.0001). The median progression-free survival and overall survival from transplant for patients with pre-transplant BMPC <5% and ≥5% was 30.8 and 115.2 months compared to 20.8 and 74.1 months, respectively (p < 0.0001 for both comparisons). The effect of pre-transplant BMPC was most pronounced in patients achieving complete response or very good partial response after transplant. In conclusion, pre-transplant BMPC <5% is an important prognostic marker of long-term survival after transplant and should be routinely incorporated into pre-transplant risk stratification.
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.|b Hospitalist Services , Essentia Health-St. Joseph's Medical Center , Brainerd , MN , USA.
authors.forename: Rajshekhar
authors.initials: R
authors.lastname: Chakraborty
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Eli
authors.initials: E
authors.lastname: Muchtar
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Shaji K
authors.initials: SK
authors.lastname: Kumar
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Francis K
authors.initials: FK
authors.lastname: Buadi
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Hayman
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hogan
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Prashant
authors.initials: P
authors.lastname: Kapoor
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Nelson
authors.initials: N
authors.lastname: Leung
authors.affiliation: a Division of Hematology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D010950:Plasma Cells / Q000473:pathology*; D057234:Preoperative Period; D011379:Prognosis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Multiple myeloma; autologous stem cell transplantation; bone marrow plasma cells