title: Impact of induction treatment before autologous stem cell transplantation on long-term outcome in patients with newly diagnosed multiple myeloma.
abstract: OBJECTIVE
  Clinical trials for patients with multiple myeloma (MM) using novel agent (NA)-based regimens before autologous stem cell transplantation (SCT) have shown improvement in response rates and progression-free survival (PFS); however they have failed to identify a significant overall survival (OS) benefit. The aim of this study was to analyze the potential impact of initial induction on the feasibility and outcome of subsequent treatment lines in a real clinical practice setting.
  
  
  METHODS
  Patients with consecutive MM <70 years of age diagnosed between 1999 and 2009 were prospectively registered and classified as having received conventional chemotherapy induction regimens with new agents available at relapse (CC cohort, 89 patients) or as treated with NAs upfront (NA cohort, 65 patients).
  
  
  RESULTS
  Patients in the NA cohort demonstrated a superior median PFS (2.8 years vs 1.6 years, P=.03) and also a median PFS from diagnosis to second progression (5.2 years vs 2.7 years, P=.003). After a median follow-up of 7 years, clear differences in OS were observed (7.97 years in NA cohort compared to 3.35 years in CC cohort, P<.001).
  
  
  CONCLUSIONS
  New agent-based first-line induction treatments provide benefits in both PFS and beyond that point, contributing to a significant improvement in OS.
authors.affiliation: ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.|Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
authors.forename: Susanna
authors.identifier: http://orcid.org/0000-0001-5506-0244
authors.initials: S
authors.lastname: Gassiot
authors.affiliation: ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.|Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Motlló
authors.affiliation: Universitat de Barcelona, Barcelona, Spain.
authors.forename: Inuska
authors.initials: I
authors.lastname: Llombart
authors.affiliation: ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Morgades
authors.affiliation: ICO-Hospital Josep Trueta, Girona, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: González
authors.affiliation: ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: Garcia-Caro
authors.affiliation: ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.|Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Ribera
authors.affiliation: ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.|Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Oriol
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D060828:Induction Chemotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D061988:Proteasome Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012044:Regression Analysis; D012074:Remission Induction; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D007155:Immunologic Factors; D061988:Proteasome Inhibitors; D003907:Dexamethasone
keywords: bone marrow transplantation; induction treatment; multiple myeloma